Derrick Meadow, APRN, PMHNP-BC, CNL

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

903854 Issued in MS

Practice address

8130 Country Village Dr Ste 103
Cordova, TN 38016-2087

Phone

(901) 308-2915

Fax

(901) 308-2924

NPI assigned

Feb 20, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN, MS2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthquest PCGroup PAC ID 6406742303, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: derrickmeadow@magnolia.medalliesdirect.net

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.

• Healthquest PC

  • Psychiatry Physician
  • Cordova, TN
  • NPI 1548229131

  MS

  Medicare reassignment Care Compare group
• Magnolia Regional Behavioral Health Services

  • Psychiatry Physician
  • Corinth, MS
  • NPI 1033656889

  Single Specialty

  Medicare reassignment NPD
• Magnolia Regional Health Center

  • General Acute Care Hospital
  • Corinth, MS
  • NPI 1699756445

  Single Specialty

  NPD

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1992338719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8130 COUNTRY VILLAGE DR STE 102",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380162087",
            "telephone_number": "901-308-2915",
            "fax_number": "901-308-2924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8130 COUNTRY VILLAGE DR STE 103",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380162087",
            "telephone_number": "901-308-2915",
            "fax_number": "901-308-2924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEADOW",
        "first_name": "DERRICK",
        "credential": "APRN, PMHNP-BC, CNL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-20",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "903854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2C6508",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T871106H",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyrstyn Nichole McNeill, NP
• Ricky Lane McPhail, PH.D.
• John D McVean, D.D.S.
• Melani Denise Meacham, MA, LPC-T, NCC
• Brooke Alyse Meadow, RBT
• Cynthia Ziegler Mealer, PH.D.
• Med Servc LLC
• Medical Necessities & Services, LLC
• Medical Necessities & Services, LLC
• Medipharm Discount Pharmacy Inc.

• Psychiatric/Mental Health Nurse Practitioner in Cordova, TN
• Providers in Cordova, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.