Individual provider Active NPI

Melissa Carol Lefave, CRNA

  • Certified Registered Nurse Anesthetist
  • Dyersburg, TN
National Provider Identifier
1609844117
Registry record updated Jul 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
055149 Issued in TN
Practice address
401 E Tickle St
Dyersburg, TN 38024-3119
Phone
(731) 285-1545
NPI assigned
Mar 9, 2006
Last updated
Jul 21, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 055149 TN Primary

Addresses

Primary practice location

401 E Tickle St
Dyersburg, TN 38024-3119

Mailing address

130 Woodland Dr
Brownsville, TN 38012-6875
Phone (731) 779-1724

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041209001016 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981661071 Reassigns benefits to 2 organizations
Practice locations: Dyersburg, TN

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Center Anesthesia, IncGroup PAC ID 2769629187, 107 clinicians

Practice addresses (Care Compare)

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000

700 W Forest Ave
Suite 100
Jackson, TN 38301-3940
Phone (731) 661-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
055149TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Center Anesthesia Inc. Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2013 Accepting new patients
West Tennessee Bone and Joint Clinic PC Nurse Anesthetist, Certified Registered CurrentSince Apr 28, 2019 Accepting new patients
Lift Therapy, Inc. Past Accepting new patients
Tipton Anesthesia Group, Inc. Nurse Anesthetist, Certified Registered PastSince May 4, 2009 Accepting new patients
Anesthesia Services of Memphis, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

24 Physicians Dr
Jackson, TN 38305
Phone (731) 661-9825

50 Capital Ave
Jackson, TN 38305
Phone (731) 661-9825

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

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.

Hospital & facility affiliations 1

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311206400000",
    "number": "1609844117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 WOODLAND DR",
            "city": "BROWNSVILLE",
            "state": "TN",
            "postal_code": "380126875",
            "telephone_number": "731-779-1724",
            "fax_number": "731-779-1724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E TICKLE ST",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380243119",
            "telephone_number": "731-285-1545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEFAVE",
        "first_name": "MELISSA",
        "middle_name": "CAROL",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2011-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "055149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyersburg, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2011; 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.