Healthcare Provider Details

I. General information

NPI: 1457026213
Provider Name (Legal Business Name): THRIVE MEDICAL GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2021
Last Update Date: 08/26/2021
Certification Date: 08/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 BOLIVAR RD
BENOIT MS
38725-9643
US

IV. Provider business mailing address

2416 FALLINGWATER LN APT 102
CORDOVA TN
38016-7686
US

V. Phone/Fax

Practice location:
  • Phone: 662-912-6024
  • Fax: 662-265-9483
Mailing address:
  • Phone: 901-870-8624
  • Fax: 662-265-9483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHARLEDRIA MCGEE
Title or Position: CEO/PROVIDER
Credential: DNP
Phone: 901-870-8624