Individual provider Active NPI

Melissa Marshall, NP-C

  • Family Nurse Practitioner
  • Crown Point, IN
National Provider Identifier
1093480576
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71011368A Issued in IN
Practice address
2100 N Main St # 304
Crown Point, IN 46307-1877
Phone
(574) 546-1900
Fax
(574) 546-1999
NPI assigned
Aug 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71011368A IN Primary

Addresses

Primary practice location

2100 N Main St # 304
Crown Point, IN 46307-1877

Mailing address

6326 Constitution Dr
Fort Wayne, IN 46804-1518
Phone (765) 669-0602

Other practice location 1

6326 Constitution Dr
Fort Wayne, IN 46804-1518
Phone (260) 515-3275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210831002772 IN Practitioner - Nurse Practitioner 3870999857 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurology and Pain Management Associates PCGroup PAC ID 4486676095, 86 clinicians

Practice addresses (Care Compare)

2100 N Main St
Suite 304
Crown Point, IN 46307-1877
Phone (574) 546-1900

Merit-based Incentive Payment System (MIPS)

Final score
23.78 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
79.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71011368AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
RP Care LLC Family CurrentSince Aug 1, 2021 Accepting new patients
Neurology and Pain Management Associates PC Family CurrentSince Mar 17, 2025 Accepting new patients

Locations

6326 Constitution Dr
Fort Wayne, IN 46804
Phone (260) 515-3275

20 John Kissinger Dr
Wabash, IN 46992
Phone (260) 274-0444

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": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1093480576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6326 CONSTITUTION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041518",
            "telephone_number": "765-669-0602",
            "fax_number": "888-803-6843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N MAIN ST # 304",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463071877",
            "telephone_number": "574-546-1900",
            "fax_number": "574-546-1999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6326 Constitution Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468041518",
            "country_code": "US",
            "telephone_number": "260-515-3275",
            "fax_number": "888-803-6843",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "MELISSA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-16",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71011368A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.