Individual provider Active NPI

Amber Elaine Mejia, RN

  • Family Nurse Practitioner
  • Dyersburg, TN
National Provider Identifier
1033970116
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
35527 Issued in TN
Practice address
179 Quail Hollow Dr
Dyersburg, TN 38024-7415
Phone
(870) 623-8410
NPI assigned
Jan 17, 2024
Last updated
Jan 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 35527 TN Primary

Addresses

Primary practice location

179 Quail Hollow Dr
Dyersburg, TN 38024-7415

Mailing address

179 Quail Hollow Dr
Dyersburg, TN 38024-7415
Phone (870) 623-8410

Other names 1

  • Amber Elaine Mayes Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240306000952 TN Practitioner - Nurse Practitioner 2567808199 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
Hometown Urgent Care of Dyersburg, PLLCGroup PAC ID 8820349202, 8 clinicians
CVC PLLCGroup PAC ID 7315364379, 6 clinicians

Practice addresses (Care Compare)

2550 Parr Ave
Dyersburg, TN 38024-2033
Phone (731) 325-5678

58 Murray Guard Dr
Jackson, TN 38305-3661
Phone (731) 513-5701

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Hometown Urgent Care of Dyersburg PLLC CurrentSince Feb 1, 2024 Accepting new patients
CVC PLLC CurrentSince Mar 10, 2025 Accepting new patients

Locations

2550 Parr Ave
Dyersburg, TN 38024
Phone (731) 325-5678

315 E Tickle St
#A
Dyersburg, TN 38024
Phone (731) 285-1933

315 E Tickle St
Ste Ab
Dyersburg, TN 38024
Phone (731) 307-8888

58 Murray Guard Dr
Jackson, TN 38305
Phone (731) 512-5701

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1033970116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 QUAIL HOLLOW DR",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380247415",
            "telephone_number": "870-623-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 QUAIL HOLLOW DR",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380247415",
            "telephone_number": "870-623-8410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEJIA",
        "first_name": "AMBER",
        "middle_name": "ELAINE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-01-17",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "35527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "MAYES",
            "middle_name": "ELAINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dyersburg, TN

Sources for this page

Verify at the official NPI Registry.