MEDICARE: LUMINOUS MINDS PSYCHIATRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1477403756
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUMINOUS MINDS PSYCHIATRY

Provider Business Mailing Address
First Line	:	1661 INTERSTATE DR STE 400
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38120
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1661 INTERSTATE DR. STE. 400
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38120
Country	:	US
Telephone Number	:	901-518-9053
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	WILLIE KELLY
Credential	:
Telephone Number	:	901-518-9053

Provider Enumeration Date	:	01/28/2026
Last Update Date	:	01/28/2026

Similar Medicare Providers

1518822972 — WANDERLUST ELITE TRANSIT
Practice Location Address:

5865 RIDGEWAY CENTER PKWY STE 300
MEMPHIS, TN
38120-4014

Practice Phone: 901-833-5592
Practice Fax:

1932714953 — VALENCIA BAYMON
Practice Location Address:

5865 RIDGEWAY CENTER PKWY STE 300
MEMPHIS, TN
38120-4014

Practice Phone: 901-405-4248
Practice Fax:

1467302380 — ENDOCRINOLOGY ASSOCIATES OF MEMPHIS
Practice Location Address:

6027 WALNUT GROVE RD STE 307
MEMPHIS, TN
38120-2128

Practice Phone: 901-681-0346
Practice Fax:

1619835311 — TIFFANY MAYFIELD DNP
Practice Location Address:

6019 WALNUT GROVE RD
MEMPHIS, TN
38120-2113

Practice Phone: 901-226-5000
Practice Fax:

1366471260 — NORMAN I HECHING MD
Practice Location Address:

100 N HUMPHREYS BLVD
MEMPHIS, TN
38120-2146

Practice Phone: 901-322-9080
Practice Fax: 901-322-9097

1689171688 — JOCK CARRINGTON LILLARD MD
Practice Location Address:

6325 HUMPHREYS BLVD
MEMPHIS, TN
38120-2300

Practice Phone: 901-522-7700
Practice Fax: 901-522-2600

Directions to “LUMINOUS MINDS PSYCHIATRY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.