Individual provider Active NPI

Melani Sidwell, NP

  • Nurse Practitioner
  • Henderson, TN
National Provider Identifier
1477091122
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
22406 Issued in TN
Practice address
656 Kimberly Dr
Henderson, TN 38340-2007
Phone
(731) 989-5180
Fax
(731) 989-5182
NPI assigned
Feb 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 22406 TN Primary

Addresses

Primary practice location

656 Kimberly Dr
Henderson, TN 38340-2007

Mailing address

656 Kimberly Dr
Henderson, TN 38340-2007
Phone (731) 989-5180

Other identifiers 1

IdentifierTypeStateIssuer
121210OtherTNRN

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
I20170828004763 TN Practitioner - Nurse Practitioner 8426321332 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christian Family Medicine, LLC 33 clinicians

Practice addresses (Care Compare)

79 Hwy 51 S
Ripley, TN 38063-4580
Phone (731) 635-8189

Merit-based Incentive Payment System (MIPS)

Final score
95.74 of 100Reported as apm
Quality
85.23
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
121210TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
WT Medical Associates CurrentSince May 1, 2024 Accepting new patients
WT Medical Associates Nurse Practitioner CurrentSince May 1, 2024 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Dec 1, 2019 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Dec 1, 2019 Accepting new patients
West Tennessee Medical Group Inc Current Accepting new patients
Medical Center Anesthesia Inc. CurrentSince Apr 30, 2017 Accepting new patients
Cardiac Anesthesia Group Past Accepting new patients
Family Medical Clinic of Trezevant PastSince Nov 21, 2021 Accepting new patients
Independent Radiology Associates PLC Past Accepting new patients
Jackson Anesthesiology Group, PLLC PastSince Dec 6, 2020 Accepting new patients
Family Medical Clinic of Trezevant Past Accepting new patients
Christian Family Medicine, LLC Past Accepting new patients

Locations

1137 S Dupree Ave
Brownsville, TN 38012
Phone (731) 779-0902

420 Wilkinson Dr
Fl 2
Dyersburg, TN 38024
Phone (731) 285-5133

1270 Union University Dr
Ste A
Jackson, TN 38305
Phone (731) 664-0103

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

1410 US Highway 70 Byp
Jackson, TN 38301
Phone (731) 421-4825

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

720 W Forest Ave
Jackson, TN 38301
Phone (731) 541-5087

9159 Telecom Dr
Milan, TN 38358
Phone (731) 215-0160

1021 Mulberry Ave
Selmer, TN 38375
Phone (731) 645-7767

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1477091122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "656 KIMBERLY DR",
            "city": "HENDERSON",
            "state": "TN",
            "postal_code": "383402007",
            "telephone_number": "731-989-5180",
            "fax_number": "731-989-5182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "656 KIMBERLY DR",
            "city": "HENDERSON",
            "state": "TN",
            "postal_code": "383402007",
            "telephone_number": "731-989-5180",
            "fax_number": "731-989-5182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDWELL",
        "first_name": "MELANI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-02",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "22406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "121210",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, TN

Sources for this page

Verify at the official NPI Registry.