Individual provider Active NPI

Melissa M Burkhardt, CNM

  • Advanced Practice Midwife
  • Vandalia, OH
National Provider Identifier
1174803910
Registry record updated Nov 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
COA.12580-NM Issued in OH
Practice address
900 S Dixie Dr
Suite 40
Vandalia, OH 45377-2657
Phone
(937) 890-6644
Fax
(937) 890-1726
NPI assigned
Aug 24, 2011
Last updated
Nov 6, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X COA.12580-NM OH Primary

Addresses

Primary practice location

900 S Dixie Dr
Suite 40
Vandalia, OH 45377-2657

Mailing address

900 S Dixie Dr
Suite 40
Vandalia, OH 45377-2657
Phone (937) 890-6644

Other identifiers 1

IdentifierTypeStateIssuer
0054038MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111028000575 OH Practitioner - Certified Nurse Midwife (CNM) 8224201769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians

Practice addresses (Care Compare)

450 N Hyatt St
Suite 304
Tipp City, OH 45371-1433
Phone (937) 832-4773

600 Aviator CT
Suite 100
Vandalia, OH 45377-9464
Phone (937) 208-7776

680 Aviator CT
Vandalia, OH 45377-9464
Phone (937) 890-6644

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
66.25
Promoting interoperability
100
Improvement activities
40
Cost
71.69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
COA.12580-NMOHMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc Current Accepting new patients
Premier Health Specialists Inc CurrentSince Sep 11, 2011 Accepting new patients
Premier Health Specialists Inc CurrentSince Sep 11, 2011 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Premier Heart Associates, Inc Past Accepting new patients

Locations

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

3170 Kettering Blvd
Bldg B
Moraine, OH 45439
Phone (937) 991-3187

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

900 S Dixie Dr
Ste 40
Vandalia, OH 45377
Phone (937) 890-6644

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1174803910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S DIXIE DR",
            "address_2": "SUITE 40",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453772657",
            "telephone_number": "937-890-6644",
            "fax_number": "937-890-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S DIXIE DR",
            "address_2": "SUITE 40",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453772657",
            "telephone_number": "937-890-6644",
            "fax_number": "937-890-1726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHARDT",
        "first_name": "MELISSA",
        "middle_name": "M",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-24",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OH",
            "license": "COA.12580-NM",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0054038",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vandalia, OH

Sources for this page

Verify at the official NPI Registry.