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General NPI Number Information
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NPI Number | 1013805019
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Entity Type | Organization
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Legal Business Name | MENDRIX MEDICAL ASSOCIATES OF TENNESSEE PC
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Dates
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Enumeration Date | 06/26/2025
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 3348 WILLIAM BAILEY DR
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City | NASHVILLE
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State | TN
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Zip | 37207-4241
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Country | US
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Telephone | 213-737-3301
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Fax | 702-977-1496
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Provider Business Mailing Address
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Address Line | 8601 LINCOLN BLVD STE 180-567
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City | LOS ANGELES
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State | CA
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Zip | 90045-3554
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Country | US
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Telephone | 213-737-3301
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Fax | 702-977-1496
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Authorized Official
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Title or Position | PRESIDENT
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Name | KACEY CALLISON
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Credential |
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Telephone | 725-710-9224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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