Active NPI
Melody Ann Russell, ACAGNP-BC
- Acute Care Nurse Practitioner
- Springfield, MO
National Provider Identifier
1114699923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 2020040257
- Practice address
- 222 E Primrose St Ste E
Springfield, MO 65807-5233 - Phone
- (417) 553-1080
- Fax
- (888) 472-5145
- NPI assigned
- Sep 30, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 2020040257 | MO | Primary |
Addresses
Primary practice location
222 E Primrose St Ste E
Springfield, MO 65807-5233
Mailing address
222 E Primrose St Ste E
Springfield, MO 65807-5233
Phone (417) 553-1080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 420118182 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Clinic Springfield Communities
Practice addresses (Care Compare)
1229 E Seminole St
Springfield, MO 65804-2227
Phone (417) 820-2064
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
Locations
448 State Highway 248
Ste 180
Branson, MO 65616
Phone (417) 820-2064
120 Hospital Dr
Ste 250
Lebanon, MO 65536
Phone (417) 533-6710
1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379
2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Springfield, MO
- NPI 1245277631
-
- Rural Health Clinic/Center
- Willow Springs, MO
- NPI 1972771657
-
- Family Medicine Physician
- Hollister, MO
- NPI 1053350454
-
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
Hospital & facility affiliations 11
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Lebanon, MO
- NPI 1447284898
-
- General Acute Care Hospital
- Rolla, MO
- NPI 1740413988
-
- General Acute Care Hospital
- Springfield, MO
- NPI 1578504056
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673913600000",
"number": "1114699923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 E PRIMROSE ST STE E",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658075233",
"telephone_number": "417-553-1080",
"fax_number": "888-472-5145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 E PRIMROSE ST STE E",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658075233",
"telephone_number": "417-553-1080",
"fax_number": "888-472-5145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "MELODY",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "ACAGNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-30",
"last_updated": "2023-01-17",
"certification_date": "2023-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "MO",
"license": "2020040257",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "420118182",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.