NPIMap

Individual provider Active NPI

Melissa Ogden, FNP

  • Nurse Practitioner
  • Kingman, AZ
National Provider Identifier
1245439330
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP2762 Issued in AZ
Practice address
2331 Hualapai Mountain Rd Ste a
Kingman, AZ 86401-6207
Phone
(928) 773-2280
Fax
(928) 773-2281
NPI assigned
Jul 17, 2007
Last updated
Feb 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP2762 AZ Primary
Family Medicine Physician 207Q00000X TAP2762 AZ

Addresses

Primary practice location

2331 Hualapai Mountain Rd Ste a
Kingman, AZ 86401-6207

Mailing address

2331 Hualapai Mountain Rd Ste a
Kingman, AZ 86401-6207
Phone (928) 773-2280

Other identifiers 2

IdentifierTypeStateIssuer
462784MedicaidAZ
TAP2762OtherAZSTATE OF ARIZONA LICENSE

Other names 1

  • Melissa Sullivan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091021000297 AZ Practitioner - Nurse Practitioner 9830236074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Arizona College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Flagstaff Center for Bone and Joint DisordersGroup PAC ID 3072411180, 28 clinicians
Paragon Physical Therapy and Rehab LLCGroup PAC ID 4284902339, 87 clinicians

Practice addresses (Care Compare)

2331 Hualapai Mountain Rd
Suite a
Kingman, AZ 86401-6207
Phone (928) 692-9668

2585 Miracle Mile
Suite 107
Bullhead City, AZ 86442-7522

525 N Switzer Canyon Dr
Flagstaff, AZ 86001-4845
Phone (928) 773-2280

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TAP2762AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Flagstaff Center for Bone and Joint Disorders CurrentSince Jan 1, 2020 Accepting new patients

Locations

525 N Switzer Canyon Dr
Flagstaff, AZ 86001
Phone (928) 773-2280

2331 Hualapai Mountain Rd
Ste A
Kingman, AZ 86401
Phone (928) 529-5086

Interoperability endpoints

  • Direct secure messaging: melissa.ogden.1@15940.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1245439330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 HUALAPAI MOUNTAIN RD STE A",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864016207",
            "telephone_number": "928-773-2280",
            "fax_number": "928-773-2281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 HUALAPAI MOUNTAIN RD STE A",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864016207",
            "telephone_number": "928-773-2280",
            "fax_number": "928-773-2281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGDEN",
        "first_name": "MELISSA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP2762",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "TAP2762",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "462784",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ARIZONA LICENSE",
            "identifier": "TAP2762",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "SULLIVAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kingman, AZ

Sources for this page

Verify at the official NPI Registry.