Provider Demographics
NPI:1649519547
Name:SHERROD, MELANIE BUCHANAN (PT)
Entity type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:BUCHANAN
Last Name:SHERROD
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 BUSBEE RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-4465
Mailing Address - Country:US
Mailing Address - Phone:865-394-0563
Mailing Address - Fax:865-376-6059
Practice Address - Street 1:40 DOGWOOD AVE
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-6400
Practice Address - Country:US
Practice Address - Phone:865-394-0563
Practice Address - Fax:865-376-6059
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000006551225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3645372Medicaid
TN3645373OtherMEDICARE PART B