Individual provider Active NPI

Melissa J Wiegand, NP

  • Family Nurse Practitioner
  • Shelby, MI
National Provider Identifier
1174904429
Registry record updated Oct 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704230188 Issued in MI
Practice address
71 Bevier St
Shelby, MI 49455-1209
Phone
(231) 861-2187
Fax
(231) 861-5100
NPI assigned
Jun 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704230188 MI Primary

Addresses

Primary practice location

71 Bevier St
Shelby, MI 49455-1209

Mailing address

PO Box 1848
Muskegon, MI 49443-1848
Phone (231) 727-5211

Other practice location 1

905 E Colby St
Whitehall, MI 49461-1262
Phone (231) 728-5910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Partners CurrentSince Sep 1, 2015 Accepting new patients
Mercy Health Partners CurrentSince Sep 1, 2015 Accepting new patients

Locations

1700 Oak Ave
Muskegon, MI 49442
Phone (231) 672-6430

71 Bevier St
Shelby, MI 49455
Phone (231) 861-2172

905 E Colby St
Whitehall, MI 49461
Phone (231) 672-8050

Organizations & group practices 2

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": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1174904429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1848",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494431848",
            "telephone_number": "231-727-5211",
            "fax_number": "231-728-4789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 BEVIER ST",
            "city": "SHELBY",
            "state": "MI",
            "postal_code": "494551209",
            "telephone_number": "231-861-2187",
            "fax_number": "231-861-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "905 E Colby St",
            "address_purpose": "LOCATION",
            "city": "Whitehall",
            "state": "MI",
            "postal_code": "494611262",
            "country_code": "US",
            "telephone_number": "231-728-5910",
            "fax_number": "231-728-5918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIEGAND",
        "first_name": "MELISSA",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-12",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704230188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.