Individual provider Active NPI

Melanie Jo Clark, MSN, APRN

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1114201795
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3006627 Issued in KY
Practice address
7926 Preston Highway
Suite 106
Louisville, KY 40219-3848
Phone
(502) 964-4357
Fax
(502) 966-5948
NPI assigned
Sep 30, 2011
Last updated
Jan 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3006627 KY Primary
Women's Health Nurse Practitioner 363LW0102X 3006627 KY

Addresses

Primary practice location

7926 Preston Highway
Suite 106
Louisville, KY 40219-3848

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address mspegal71096@direct.nortonhealthcare.org
FHIR URL https://epicsoap.nortonhealthcare.org/
Direct Messaging Address mspegal71096@direct.nortonhealthcare.org
FHIR URL https://epicsoap.nortonhealthcare.org/

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
I20130912000299 KY Practitioner - Nurse Practitioner 5395989362 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

1023 New Moody LN
Suite 103
La Grange, KY 40031-9179
Phone (502) 222-5558

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
3006627KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Aug 7, 2013 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Aug 7, 2013 Accepting new patients
Baptist Medical Associates Inc CurrentSince Oct 5, 2022 Accepting new patients
Community Medical Associates, Inc. Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

2051 Clevidence Blvd
Clarksville, IN 47129
Phone (812) 280-6650

2051 Clevidence Blvd
Ste A
Clarksville, IN 47129
Phone (812) 280-1720

1023 New Moody Ln
Ste 103
Lagrange, KY 40031
Phone (502) 222-5558

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

Organizations & group practices 6

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 2

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": "1317340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1114201795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7926 PRESTON HIGHWAY",
            "address_2": "SUITE 106",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402193848",
            "telephone_number": "502-964-4357",
            "fax_number": "502-966-5948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MELANIE",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-30",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3006627",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "KY",
            "license": "3006627",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mspegal71096@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "7926 Preston Highway",
            "address_2": "Suite 106",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402193848",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/",
            "affiliation": "N",
            "address_1": "7926 Preston Highway",
            "address_2": "Suite 106",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402193848",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mspegal71096@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "7926 Preston Highway",
            "address_2": "Suite 106",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402193848",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/",
            "affiliation": "N",
            "address_1": "7926 Preston Highway",
            "address_2": "Suite 106",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402193848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.