Melissa D Merrill, CNM, WHNP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

NP1172A Issued in ID

Practice address

132 5TH Ave W
Jerome, ID 83338-1825

Phone

(208) 324-5286

Fax

(208) 324-9815

NPI assigned

Feb 5, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Melissa Vitek Former name

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

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.

• St Luke'S Clinic LLC

  • Family Medicine Physician
  • Twin Falls, ID
  • NPI 1790718229
  Medicare reassignment NPD

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

{
    "created_epoch": "1233792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420588800000",
    "number": "1043459696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 5TH AVE W",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833381825",
            "telephone_number": "208-324-5286",
            "fax_number": "208-324-9815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 5TH AVE W",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833381825",
            "telephone_number": "208-324-5286",
            "fax_number": "208-324-9815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRILL",
        "first_name": "MELISSA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "CNM, WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-05",
        "last_updated": "2015-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "ID",
            "license": "19862A",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "ID",
            "license": "NP1172A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "000010171795",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808284700",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "NP311",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "VITEK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Magic Valley Midwifery, LLC
• Christa A Mahler, BCBA
• Chandi Delyn Marston, LMSW
• Mayes Physical Therapy, Inc
• Daryl Dean Mayes, P.T., D.P.T., M.H.S.
• Jamey Lee Miller
• Sarah Elizabeth Miller
• Toni R Miller, FNP
• Robin Ann Moore, BSW
• Danielle Myers

• Women's Health Nurse Practitioner in Jerome, ID
• Providers in Jerome, ID by specialty
• Women's Health Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.