Family Practice Clinic, PC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

6331 Issued in TN

Legal business name

FAMILY PRACTICE CLINIC, PC

Practice address

1445 Parr Ave
Dyersburg, TN 38024-3153

Phone

(731) 286-6156

Fax

(731) 286-6797

NPI assigned

Feb 1, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Shari P Tidwell, APRN, FNP-CNPI 1912906421

Title

Owner/Provider

Phone

(731) 286-6156

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16690/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shari P Tidwell, F.NP.

  • Family Nurse Practitioner
  • Dyersburg, TN
  • NPI 1912906421
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1328054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763596800000",
    "number": "1023380474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 PARR AVE",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380243153",
            "telephone_number": "731-286-6156",
            "fax_number": "731-286-6797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 PARR AVE",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380243153",
            "telephone_number": "731-286-6156",
            "fax_number": "731-286-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-01",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A",
        "authorized_official_last_name": "TIDWELL",
        "authorized_official_first_name": "SHARI",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "731-286-6156",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN, FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "6331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Dyersburg, TN
• Providers in Dyersburg, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.