Individual provider Active NPI

Melissa Ann Carson, FNP-C

  • Family Nurse Practitioner
  • Jackson, TN
National Provider Identifier
1295449221
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F10221171 Issued in TN
Practice address
285 Old Malesus Rd
Jackson, TN 38301-7867
Phone
(731) 693-2353
NPI assigned
Jan 13, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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 F10221171 TN Primary

Addresses

Primary practice location

285 Old Malesus Rd
Jackson, TN 38301-7867

Mailing address

285 Old Malesus Rd
Jackson, TN 38301-7867
Phone (731) 693-2353

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
I20230725000407 TN Practitioner - Nurse Practitioner 5395105282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Madison County General HospitalGroup PAC ID 3678481975, 55 clinicians

Practice addresses (Care Compare)

367 Hospital Blvd
Jackson, TN 38305-2080
Phone (731) 541-6834

Hospital & facility affiliations

  • Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002
  • Dyersburg Regional Medical Center Hospital, Dyersburg, TN, CCN 440072
  • West Tennessee Healthcare Milan Hospital Hospital, Milan, TN, CCN 440060

Merit-based Incentive Payment System (MIPS)

Final score
77.21 of 100Reported as group
Quality
64.19
Improvement activities
40
Cost
79.33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F10221171TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Madison County General Hospital CurrentSince Jun 2, 2023 Accepting new patients
Jackson Madison County General Hospital CurrentSince Jun 2, 2023 Accepting new patients

Locations

650 Nuckolls Rd
Bolivar, TN 38008
Phone (731) 541-6834

24 Physicians Dr
Cookeville, TN 38505

257 Bancorp South Pkwy
Jackson, TN 38305
Phone (731) 512-1283

367 Hospital Blvd
Jackson, TN 38305
Phone (731) 661-2000

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1673568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1295449221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 OLD MALESUS RD",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383017867",
            "telephone_number": "731-693-2353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 OLD MALESUS RD",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383017867",
            "telephone_number": "731-693-2353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-13",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "F10221171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.