Individual provider Active NPI

Melissa F Halvorson, MD

  • Obstetrics & Gynecology Physician
  • Saint Johns, MI
National Provider Identifier
1114994365
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MH070380 Issued in MI
Practice address
1005 S US Highway 27 Ste 100
Saint Johns, MI 48879-2423
Phone
(989) 224-3000
Fax
(989) 668-0423
NPI assigned
Mar 7, 2006
Last updated
Jan 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MH070380 MI Primary

Addresses

Primary practice location

1005 S US Highway 27 Ste 100
Saint Johns, MI 48879-2423

Mailing address

1560 Turf Lane
East Lansing, MI 48823-6392
Phone (517) 484-3000

Other identifiers 5

IdentifierTypeStateIssuer
0331169OtherMIBCBS/BCN PROVIDER #
1016279OtherMIMCLAREN PROVIDER #
0770053OtherMIPHP FAMILYCARE PROVIDER #
4662800MedicaidMI
0700378OtherMIPHP PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040825001235 MI Practitioner - Obstetrics/Gynecology 2961476767 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MH070380MIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W Sparrow Hospital Association CurrentSince Jan 1, 2006 Accepting new patients
West Branch Regional Medical Center Current Accepting new patients
Edward W. Sparrow Hospital Association Obstetrics & Gynecology CurrentSince Jan 1, 2006 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Uwh of Michigan PLC Obstetrics & Gynecology CurrentSince Mar 20, 2022 Accepting new patients
Catherine McAuley Health Services Corporation Obstetrics & Gynecology Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

1560 Turf Ln
East Lansing, MI 48823
Phone (517) 484-3000

1575 Ramblewood Dr
Ste 100
East Lansing, MI 48823
Phone (517) 364-3659

1200 E Michigan Ave
Ste 345
Lansing, MI 48912
Phone (517) 364-5610

1322 E Michigan Ave
Ste 220
Lansing, MI 48912
Phone (517) 364-2570

1100 S Cedar St
Mason, MI 48854
Phone (517) 484-3000

1457 N M 52
Ste 2
Owosso, MI 48867
Phone (989) 723-5136

2431 S M 30
Ste 200
West Branch, MI 48661
Phone (989) 343-3762

2463 S M 30
West Branch, MI 48661
Phone (517) 345-3660

2463 S M 30
Ste 200
West Branch, MI 48661

Interoperability endpoints

  • Direct secure messaging: melissahalvorson@aog.allscriptsdirect.net
  • Direct secure messaging: melissahalvorson@ccmedc.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1114994365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 TURF LANE",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488236392",
            "telephone_number": "517-484-3000",
            "fax_number": "517-484-6358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 S US HIGHWAY 27 STE 100",
            "city": "SAINT JOHNS",
            "state": "MI",
            "postal_code": "488792423",
            "telephone_number": "989-224-3000",
            "fax_number": "989-668-0423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALVORSON",
        "first_name": "MELISSA",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-07",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "MH070380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS/BCN PROVIDER #",
            "identifier": "0331169",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN PROVIDER #",
            "identifier": "1016279",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP FAMILYCARE PROVIDER #",
            "identifier": "0770053",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4662800",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP PROVIDER #",
            "identifier": "0700378",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Johns, MI

Sources for this page

Verify at the official NPI Registry.