Individual provider Active NPI

Melissa G Marcombe, FNP

  • Family Nurse Practitioner
  • Gray, LA
National Provider Identifier
1124256706
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP05918 Issued in LA
Practice address
191 Innovation CT Ste a
Gray, LA 70359-3131
Phone
(985) 303-4100
Fax
(985) 303-4101
NPI assigned
Jun 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN084371-AP05918 LA
Family Nurse Practitioner 363LF0000X AP05918 LA Primary

Addresses

Primary practice location

191 Innovation CT Ste a
Gray, LA 70359-3131

Mailing address

191 Innovation CT Ste a
Gray, LA 70359-3131
Phone (985) 303-4100

Other practice location 1

13030 Highway 308
LaRose, LA 70373-2001
Phone (985) 798-7000

Other identifiers 1

IdentifierTypeStateIssuer
1802166MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20090923000252 LA Practitioner - Nurse Practitioner 9638225295 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
Riverside Urgent CareGroup PAC ID 7214075993, 6 clinicians

Practice addresses (Care Compare)

3317 New Hwy 51
La Place, LA 70068-6438
Phone (985) 233-3317

3317 US
Suite 51
La Place, LA 70068-6438

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN084371-AP05918LAMDNurse Practitioner
AP05918LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Dec 19, 2017 Accepting new patients
Ochsner Clinic LLC CurrentSince Dec 19, 2017 Accepting new patients
Ochsner Bayou LLC Current Accepting new patients
Cardiovascular Institute of the South, LLC Nurse Practitioner CurrentSince Oct 15, 2024 Accepting new patients

Locations

191 Innovation Ct
Ste A
Gray, LA 70359
Phone (985) 303-4050

1901 Manhattan Blvd
Ste A200
Harvey, LA 70058
Phone (504) 354-5252

225 Dunn St
Houma, LA 70360
Phone (985) 446-2021

500 N Lewis St
Ste 100
New Iberia, LA 70563
Phone (337) 367-5200

4608 Highway 1
Raceland, LA 70394
Phone (504) 537-6841

106 Cypress St
Raceland, LA 70394
Phone (985) 446-1958

Organizations & group practices 5

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": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1124256706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 INNOVATION CT STE A",
            "city": "GRAY",
            "state": "LA",
            "postal_code": "703593131",
            "telephone_number": "985-303-4100",
            "fax_number": "985-303-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 INNOVATION CT STE A",
            "city": "GRAY",
            "state": "LA",
            "postal_code": "703593131",
            "telephone_number": "985-303-4100",
            "fax_number": "985-303-4101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13030 Highway 308",
            "address_purpose": "LOCATION",
            "city": "LaRose",
            "state": "LA",
            "postal_code": "703732001",
            "country_code": "US",
            "telephone_number": "985-798-7000",
            "fax_number": "985-798-7021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCOMBE",
        "first_name": "MELISSA",
        "middle_name": "G",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-23",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "RN084371-AP05918",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP05918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1802166",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gray, LA

Sources for this page

Verify at the official NPI Registry.