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

Robert Decolli III, CRNP

Individual provider Nurse Practitioner · NPI 1558993279

Robert Decolli III, CRNP is a Nurse Practitioner in Memphis, Tennessee. Qualified in 2019, 7 years ago. Practices with Specialty Physician Group LLC, a 101-clinician group, works from 6 locations, accepts Medicare assignment and offers telehealth. Licensed in Mississippi, Pennsylvania and Tennessee.

Years since qualifying
7
Licensed in
MS, PA, TN
In the registry since
2020
Specialties on file
3
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

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Practice location Address checks out

1211 Union Ave Ste 965
Memphis, TN 38104-6638
Phone: (901) 435-8550
Fax: (901) 478-0781
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (5)

  • 1938 Crescent Meadows Dr, Holly Springs, MS 38635-7419 — (901) 435-8550
  • 7460 Wolf River Blvd, Germantown, TN 38138-1760 — (901) 763-0200
  • 1265 Union Ave, Memphis, TN 38104-3415 — (901) 516-2362
  • 1251 Wesley Dr Ste 100, Memphis, TN 38116-6442 — (901) 435-8550
  • 3725 Champion Hills Dr Ste 2000, Memphis, TN 38125-2510 — (901) 763-0200

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 31566 (TN)
Nurse Practitioner Taxonomy 363L00000X · Licence SP021499 (PA)
Nurse Practitioner Taxonomy 363L00000X · Licence 906328 (MS)

Record details

NPI number1558993279
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNP
Sole proprietorNo
NPI enumeratedFebruary 11, 2020
Last updated in NPPESJuly 29, 2026
Certification dateJuly 29, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Specialty Physician Group Llc — 101 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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