Individual provider Active NPI

Nicole Meadows

  • Clinical Social Worker
  • Lynnville, TN
National Provider Identifier
1902212079
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW 6149 Issued in TN
Practice address
2037 Petty Hollow Rd N
Lynnville, TN 38472-5544
Phone
(931) 347-7321
NPI assigned
Jul 9, 2014
Last updated
Feb 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW 6149 TN Primary

Addresses

Primary practice location

2037 Petty Hollow Rd N
Lynnville, TN 38472-5544

Mailing address

2037 Petty Hollow Rd N
Lynnville, TN 38472-5544
Phone (931) 347-7321

Other names 1

  • Nicole Meadows Professional 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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151030000805 TN Practitioner - Clinical Social Worker 7416267646 Practice locations: Lynnville, TN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2037 Petty Hollow N Rd
Lynnville, TN 38472-5544

2037 Petty Hollow Rd N
Lynnville, TN 38472-5544
Phone (931) 347-7321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW 6149TNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1902212079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2037 PETTY HOLLOW RD N",
            "city": "LYNNVILLE",
            "state": "TN",
            "postal_code": "384725544",
            "telephone_number": "931-347-7321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2037 PETTY HOLLOW RD N",
            "city": "LYNNVILLE",
            "state": "TN",
            "postal_code": "384725544",
            "telephone_number": "931-347-7321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEADOWS",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-09",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LCSW 6149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "MEADOWS",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lynnville, TN

Sources for this page

Verify at the official NPI Registry.