Individual provider Active NPI

Melissa Lynn Vandiver, MN-FNP

  • Primary Care Nurse Practitioner
  • New Orleans, LA
National Provider Identifier
1164836136
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
AP07833 Issued in LA
Practice address
1936 Magazine St
New Orleans, LA 70130-5016
Phone
(045) 295-5585
Fax
(985) 888-1838
NPI assigned
Jun 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X AP07833 LA Primary

Addresses

Primary practice location

1936 Magazine St
New Orleans, LA 70130-5016

Mailing address

119 Charwood Dr
Pearl River, LA 70452-3701
Phone (985) 960-3634

Other names 1

  • Melissa Lynn Gilmore Pitts Former name

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
I20140929000373 LA Practitioner - Nurse Practitioner 0941420897 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3943 Saint Bernard Ave
New Orleans, LA 70122-1147
Phone 5045295558466

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Segura Wellness, LLC CurrentSince Apr 16, 2022 Accepting new patients
St. Thomas Community Health Center, Inc CurrentSince Apr 1, 2024 Accepting new patients
Concerned Care Palliative Services LLC CurrentSince May 23, 2024 Accepting new patients
St. Thomas Community Health Center, Inc. CurrentSince Apr 1, 2024 Accepting new patients
Slidell Memorial Hospital Past Accepting new patients
Gulf Coast Rheumatology PastSince Jul 14, 2011 Accepting new patients
St. Thomas Community Health Center, Inc Past Accepting new patients
St. Thomas Community Health Center, Inc Past Accepting new patients
St. Thomas Community Health Center, Inc. Past Accepting new patients
St. Thomas Community Health Center, Inc. Past Accepting new patients
St. Thomas Community Health Center, Inc. Past Accepting new patients

Locations

125 N Theard St
Ste C
Covington, LA 70433
Phone (504) 210-1971

141 Lakeview Cir
Covington, LA 70433
Phone (985) 231-6751

230 Ochsner Blvd
Gretna, LA 70056

3621 Ridgelake Dr
Ste 201
Metairie, LA 70002
Phone (504) 210-1971

1200 L B Landry Ave
New Orleans, LA 70114
Phone (504) 302-7170

2000 Magazine St
New Orleans, LA 70130
Phone (504) 529-5888

3500 Holiday Dr
New Orleans, LA 70114
Phone (504) 367-5724

1020 Saint Andrew St
New Orleans, LA 70130

1936 Magazine St
New Orleans, LA 70130

2014 Magazine St
New Orleans, LA 70130
Phone (504) 529-9115

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GDBCBD

Organizations & group practices 11

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": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1164836136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 CHARWOOD DR",
            "city": "PEARL RIVER",
            "state": "LA",
            "postal_code": "704523701",
            "telephone_number": "985-960-3634",
            "fax_number": "985-888-1838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1936 MAGAZINE ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701305016",
            "telephone_number": "045-295-5585",
            "fax_number": "985-888-1838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDIVER",
        "first_name": "MELISSA",
        "middle_name": "LYNN",
        "credential": "MN-FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "LA",
            "license": "AP07833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "PITTS",
            "middle_name": "LYNN GILMORE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.