Provider Demographics
NPI:1457026213
Name:THRIVE MEDICAL GROUP, PLLC
Entity Type:Organization
Organization Name:THRIVE MEDICAL GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLEDRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGEE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:901-870-8624
Mailing Address - Street 1:2416 FALLINGWATER LN APT 102
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-7686
Mailing Address - Country:US
Mailing Address - Phone:901-870-8624
Mailing Address - Fax:662-265-9483
Practice Address - Street 1:207 BOLIVAR RD
Practice Address - Street 2:
Practice Address - City:BENOIT
Practice Address - State:MS
Practice Address - Zip Code:38725-9643
Practice Address - Country:US
Practice Address - Phone:662-912-6024
Practice Address - Fax:662-265-9483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-13
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty