Individual provider Active NPI

Melissa K Johnson, NP

  • Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1184136038
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71007534A Issued in IN
Practice address
1801 N Senate Blvd Ste 230
Indianapolis, IN 46202-1252
Phone
(317) 962-5820
Fax
(317) 962-3916
NPI assigned
Nov 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71007534A IN Primary

Addresses

Primary practice location

1801 N Senate Blvd Ste 230
Indianapolis, IN 46202-1252

Mailing address

1801 N Senate Blvd Ste 230
Indianapolis, IN 46202-1252
Phone (317) 962-5820

Other practice location 1

1550 E County Line Rd Ste 325
Indianapolis, IN 46227-0967
Phone (317) 497-6666

Other identifiers 1

IdentifierTypeStateIssuer
300010421MedicaidIN

Other names 1

  • Melissa K Maier Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20180105000716 IN Practitioner - Nurse Practitioner 7810256450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Indiana Medical College, School of Medicine of Purdue University, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

1550 E County Line Rd
Suite 325
Indianapolis, IN 46227-0967
Phone (317) 355-1470

Hospital & facility affiliations

  • Community Hospital South, Inc. Hospital, Indianapolis, IN, CCN 150128

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71007534AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Sep 1, 2019 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Sep 1, 2019 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

1550 E County Line Rd
Ste 325
Indianapolis, IN 46227
Phone (317) 467-6270

Interoperability endpoints

  • Direct secure messaging: mjohnson352737@ecommunitydirect.com

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.

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": "1509494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1184136038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 N SENATE BLVD STE 230",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021252",
            "telephone_number": "317-962-5820",
            "fax_number": "317-962-3916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N SENATE BLVD STE 230",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021252",
            "telephone_number": "317-962-5820",
            "fax_number": "317-962-3916"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1550 E County Line Rd Ste 325",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462270967",
            "country_code": "US",
            "telephone_number": "317-497-6666",
            "fax_number": "317-497-2533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MELISSA",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-01",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71007534A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300010421",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "MAIER",
            "middle_name": "K",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.