Healthcare Provider Details

I. General information

NPI: 1124812763
Provider Name (Legal Business Name): ESSENTIAL PRIMARY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6005 PARK AVE STE 503
MEMPHIS TN
38119-5215
US

IV. Provider business mailing address

6005 PARK AVE STE 503
MEMPHIS TN
38119-5215
US

V. Phone/Fax

Practice location:
  • Phone: 901-634-8816
  • Fax:
Mailing address:
  • Phone: 901-779-3527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY GAIL ANDERSON
Title or Position: PRESIDENT
Credential: FNP
Phone: 901-779-3527