Individual provider Active NPI

Melissa Gillette, PHD, MS, CGC

  • Genetic Counselor (M.S.)
  • Indianapolis, IN
National Provider Identifier
1033529938
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Genetic Counselor (M.S.)Taxonomy code 170300000X
License
74000032A Issued in IN
Practice address
975 W Walnut St # Ib130
Indianapolis, IN 46202-5181
Phone
(317) 944-3966
Fax
(317) 968-1354
NPI assigned
Apr 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Genetic Counselor (M.S.) 170300000X
Genetic Counselor (M.S.) 170300000X 74000032A IN Primary

Addresses

Primary practice location

975 W Walnut St # Ib130
Indianapolis, IN 46202-5181

Mailing address

975 W Walnut St # Ib130
Indianapolis, IN 46202-5181
Phone (317) 944-3966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
74000032AINMDGenetic Counselor (M.S.)

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC Past Accepting new patients
Indiana University Medical Genetics Service, Inc. PastSince Nov 17, 2024 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1033529938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 W WALNUT ST # IB130",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025181",
            "telephone_number": "317-944-3966",
            "fax_number": "317-968-1354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 W WALNUT ST # IB130",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025181",
            "telephone_number": "317-944-3966",
            "fax_number": "317-968-1354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLETTE",
        "first_name": "MELISSA",
        "name_prefix": "Dr.",
        "credential": "PHD, MS, CGC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-30",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "IN",
            "license": "74000032A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.