Melissa A Hathhorn, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

67969 Issued in ID

Practice address

360 E Liberty St
Weiser, ID 83672-2261

Phone

(208) 549-4424

NPI assigned

Apr 21, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Weiser Valley Hospital DistrictGroup PAC ID 5294704276, 60 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Weiser Valley Hospital District

  • Family Medicine Physician
  • Weiser, ID
  • NPI 1255364030
  Medicare reassignment Care Compare group NPD
• Weiser Valley Hospital District

  • Critical Access Hospital
  • Boise, ID
  • NPI 1639373772
  NPD

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1124609029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 W 2ND ST",
            "city": "WEISER",
            "state": "ID",
            "postal_code": "836721809",
            "telephone_number": "360-798-8127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E LIBERTY ST",
            "city": "WEISER",
            "state": "ID",
            "postal_code": "836722261",
            "telephone_number": "208-549-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATHHORN",
        "first_name": "MELISSA",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "67969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Gonzalez
• Michelle Lynn Grendahl, LPC
• Janice Elaine Grimaldo, SLP
• Tom Gudmestad, DDS
• Kent Leroy Hamilton, PAC
• Laura Haun, A.T.C.
• Duane Ray Hess, DC
• Craig Philip Hessing, DPT
• Gary L. Hoopes, P.T.
• Suzanna Dyann Hubele, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Weiser, ID
• Providers in Weiser, ID by specialty
• Psychiatric/Mental Health Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.

Verify at the official NPI Registry.