FAMILY PRACTICE CLINIC, PC
NPI 1023380474
Nurse Practitioner - Family in Dyersburg, TN

NPI Status: Active since February 01, 2012

Contact Information

1445 PARR AVE
DYERSBURG, TN
ZIP 38024
Phone: (731) 286-6156
Fax: (731) 286-6797

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  • Organization
  • Nurse Practitioner
  • Family
  • CLIA Number: 44D0962574
  • CLIA Cert. Type: Practitioner Other
  • CLIA Exp. Date: 07-07-2027

About FAMILY PRACTICE CLINIC, PC

This page provides the complete NPI Profile along with additional information for Family Practice Clinic, Pc, a provider established in Dyersburg, Tennessee operating as a Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1023380474 assigned on February 2012. The practitioner's primary taxonomy code is 363LF0000X with license number 6331 (TN). The provider is registered as an organization and their NPI record was last updated one year ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Ms. Shari P Tidwell Aprn, Fnp-c (Owner/provider)

NPI
1023380474
Provider Name
FAMILY PRACTICE CLINIC, PC
Entity Type
Organization
Location Address
1445 PARR AVE DYERSBURG, TN 38024
Location Phone
(731) 286-6156
Location Fax
(731) 286-6797
Mailing Address
1445 PARR AVE DYERSBURG, TN 38024
Mailing Phone
(731) 286-6156
Mailing Fax
(731) 286-6797
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-01-2012
Last Update Date
11-20-2025
Code Navigator

A nurse practitioner (NP) like Family Practice Clinic, Pc is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Practitioner Family

Taxonomy Code
363LF0000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
6331
License State
TN

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MS. SHARI P TIDWELL APRN, FNP-C

Authorized Official Title
OWNER/PROVIDER
Authorized Official Phone
(731) 286-6156

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
44D0962574
Facility Type
Practitioner Other
Certificate Effective Date
July 08, 2025
Certificate Expiration Date
July 07, 2027
Laboratory Director
SHARI P. TIDWELL
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Family Practice Clinic, Pc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1023380474, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
2
Doubled → 4
Pos 4
3
Unchanged
Pos 5
3
Doubled → 6
Pos 6
8
Unchanged
Pos 7
0
Doubled → 0
Pos 8
4
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 3 → 6 0 → 0 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 4 + 3 + 6 + 8 + 0 + 4 + 1 + 4 + 24 = 56

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1023380474.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Physical Therapist
1445 PARR AVE
DYERSBURG, TN 38024
Physical Therapist
1445 PARR AVE
DYERSBURG, TN 38024
Nurse Practitioner (Family)
1445 PARR AVE
DYERSBURG, TN 38024

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1023380474, enumerated as an "organization" on February 01, 2012.

The provider is located at 1445 PARR AVE DYERSBURG, TN 38024 and the phone number is (731) 286-6156.

Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.