Provider Demographics
NPI:1811994700
Name:COUNTS, MELODY (MD)
Entity type:Individual
Prefix:DR
First Name:MELODY
Middle Name:
Last Name:COUNTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 4TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37821-3762
Mailing Address - Country:US
Mailing Address - Phone:423-623-6240
Mailing Address - Fax:423-623-0102
Practice Address - Street 1:407 4TH ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-3762
Practice Address - Country:US
Practice Address - Phone:423-623-6240
Practice Address - Fax:423-623-0102
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101233837207Q00000X
TN63783207QA0401X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1811994700Medicaid
VAP01265431OtherRAILROAD MEDICARE
TNQ008401Medicaid
TNQ008401Medicaid
VAP01265431OtherRAILROAD MEDICARE
VA1811994700Medicaid