Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lynnette K Prokop, PA

Individual provider Physician Assistant · NPI 1205292497

Lynnette K Prokop, PA is a Physician Assistant in Memphis, Tennessee. Qualified in 2015, 11 years ago. Practices with University Hospitals Medical Group Inc, a 2,242-clinician group and accepts Medicare assignment. Licensed in Ohio and Tennessee.

Years since qualifying
11
Licensed in
OH, TN
In the registry since
2016
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1325 Eastmoreland Ave Ste 310
Memphis, TN 38104-7544
Phone: (901) 758-7970
Fax: (901) 266-6425
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 4968 (TN)
Physician Assistant Taxonomy 363A00000X · Licence 50.004572RX (OH)

Record details

NPI number1205292497
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 5, 2016
Last updated in NPPESApril 5, 2022
Certification dateApril 5, 2022
Mailing address1211 Union Ave Ste 330, Memphis, TN 38104-6655

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice University Hospitals Medical Group Inc — 2242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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