Individual provider Active NPI

Melinda S Mosby, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Jackson, TN
National Provider Identifier
1548445562
Registry record updated May 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
19834 Issued in TN
Practice address
238 Summar Dr
Jackson, TN 38301
Phone
(731) 541-8200
Fax
(731) 541-8327
NPI assigned
Jan 9, 2008
Last updated
May 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 19834 TN Primary
Registered Nurse 163W00000X RN0000124100 TN

Addresses

Primary practice location

238 Summar Dr
Jackson, TN 38301

Mailing address

1804 Highway 45 Byp Ste 604
Jackson, TN 38305-4403
Phone (731) 660-8781

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
I20150824000336 TN Practitioner - Nurse Practitioner 3779898531 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Professional Care Services of West TN, Inc.Group PAC ID 0042115537, 12 clinicians

Practice addresses (Care Compare)

2380 Henry St
Dyersburg, TN 38024-1847
Phone (844) 727-2778

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN0000124100TNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
State of Tennessee CurrentSince Apr 9, 2015 Accepting new patients
Professional Care Services of West TN, Inc. CurrentSince Feb 4, 2026 Accepting new patients
State of Tennessee State F & a Payroll CurrentSince Apr 9, 2015 Accepting new patients
State of Tennessee Current Accepting new patients
Pathways of Tennessee, Inc. CurrentSince May 19, 2018 Accepting new patients

Locations

1120 Tammbell St
Brownsville, TN 38012
Phone (731) 541-8344

130 W Main St
Brownsville, TN 38012
Phone (731) 772-9002

1720 Woodlawn Ave
Dyersburg, TN 38024
Phone (731) 285-1393

2380 Henry St
Dyersburg, TN 38024
Phone (731) 287-1794

1270 Union University Dr
Ste D
Jackson, TN 38305
Phone (731) 265-6450

238 Summar Dr
Jackson, TN 38301
Phone (731) 541-8200

33 Directors Row
Ste A
Jackson, TN 38305
Phone (731) 541-7605

9550 Highway 412 W
Ste B
Lexington, TN 38351
Phone (731) 968-8197

951 Court Ave
Memphis, TN 38103
Phone (901) 577-1800

500 Deaderick St
Bldg 6TH
Nashville, TN 37242

223 S Court St
Tiptonville, TN 38079
Phone (731) 253-7780

930 Mount Zion Rd
Union City, TN 38261
Phone (731) 885-9333

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526515200000",
    "number": "1548445562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 HIGHWAY 45 BYP STE 604",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383054403",
            "telephone_number": "731-660-8781",
            "fax_number": "731-660-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38301",
            "telephone_number": "731-541-8200",
            "fax_number": "731-541-8327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSBY",
        "first_name": "MELINDA",
        "middle_name": "S",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-09",
        "last_updated": "2018-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "19834",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN0000124100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.