Individual provider Active NPI

Melissa Johnson, A.P.R.N.

  • Clinical Nurse Specialist
  • Murray, KY
National Provider Identifier
1104230598
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
3007776 Issued in KY
Practice address
300 S 8TH St Ste 380W
Murray, KY 42071-2442
Phone
(270) 753-0704
Fax
(270) 752-2852
NPI assigned
Jun 13, 2014
Last updated
Nov 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X 3007776 KY Primary

Addresses

Primary practice location

300 S 8TH St Ste 380W
Murray, KY 42071-2442

Mailing address

300 S 8TH St
Ste 480W
Murray, KY 42071-2400
Phone (270) 753-0704

Other practice location 1

136 Wells Hall
Murray, KY 42071-3318
Phone (270) 809-3809

Other identifiers 1

IdentifierTypeStateIssuer
7100352510MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20140902001642 KY Practitioner - Nurse Practitioner 4385862424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 S 8TH St
Suite 380W
Murray, KY 42071-2442
Phone (270) 753-0704

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.99 of 100Reported as group
Quality
73.34
Promoting interoperability
100
Improvement activities
40
Cost
73.31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3007776KYMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Murray-Calloway County Public Hospital Corporation CurrentSince Jul 1, 2014 Accepting new patients
Murray-Calloway County Public Hospital Corporation Clinical Nurse Specialist Current Accepting new patients
Murray-Calloway County Public Hospital Corporation CurrentSince Jul 1, 2014 Accepting new patients

Locations

136 Wells Hall
Murray, KY 42071
Phone (270) 809-3809

300 S 8th St
Ste 380W
Murray, KY 42071
Phone (270) 753-0704

300 S 8th St
Ste 480W
Murray, KY 42071
Phone (270) 762-1104

803 Poplar St
Murray, KY 42071
Phone (270) 762-1155

Interoperability endpoints

  • Direct secure messaging: melissa.johnson.3@9266.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1402617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1104230598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S 8TH ST",
            "address_2": "STE 480W",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420712400",
            "telephone_number": "270-753-0704",
            "fax_number": "270-752-2852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S 8TH ST STE 380W",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420712442",
            "telephone_number": "270-753-0704",
            "fax_number": "270-752-2852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "136 Wells Hall",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "KY",
            "postal_code": "420713318",
            "country_code": "US",
            "telephone_number": "270-809-3809",
            "fax_number": "270-752-2852",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MELISSA",
        "name_prefix": "Mrs.",
        "credential": "A.P.R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "KY",
            "license": "3007776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100352510",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, KY

Sources for this page

Verify at the official NPI Registry.