Melissa Dawn Slack, APRN

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

CNP.0029805 Issued in OH

Practice address

12134 Old Dayton Rd
Brookville, OH 45309-8361

Phone

(937) 416-8874

NPI assigned

Sep 21, 2021

Last updated

Sep 21, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, IN2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healogics Specialty Physicians of Ohio, LLCGroup PAC ID 1759607229, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fidelity Health Care Home health agency, Moraine, OH, CCN 367160
• Upper Valley Medical Center Hospital, Troy, OH, CCN 360174

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Healogics Specialty Physicians of Ohio, LLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Troy, OH
  • NPI 1124430491

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Healogics Specialty Physicians of Indiana, LLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Terre Haute, IN
  • NPI 1396145975

  Family Medicine

  Medicare reassignment NPD
• PHS Emergency Billing LLC

  • Emergency Medicine Physician
  • Dayton, OH
  • NPI 1578387486
  Medicare reassignment
• Molina Care Connections, LLC.

  dba Molina CC

  • Nurse Practitioner
  • Long Beach, CA
  • NPI 1407243223

  OH

  Medicare reassignment

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

• Fidelity Health Care Inc

  dba Fidelity Nursing Systems

  • Home Health Agency
  • Moraine, OH
  • NPI 1235127838
  Care Compare affiliation
• Upper Valley Medical Center

  • General Acute Care Hospital
  • Troy, OH
  • NPI 1184638942
  Care Compare affiliation

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1265103261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12134 OLD DAYTON RD",
            "city": "BROOKVILLE",
            "state": "OH",
            "postal_code": "453098361",
            "telephone_number": "937-416-8874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12134 OLD DAYTON RD",
            "city": "BROOKVILLE",
            "state": "OH",
            "postal_code": "453098361",
            "telephone_number": "937-416-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLACK",
        "first_name": "MELISSA",
        "middle_name": "DAWN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-21",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "CNP.0029805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott L Hora OD LLC
• Elaine Kay Scott, CRNP
• Anthony H Shaffer, D.C.
• Randall R Shaffer, D.C.
• Tonya Lynn Singleton, LPN
• Deborah Dawn Smith, RN
• Southwest Ohio Home Care LLC
• Brian Keith Stinson Jr.
• Studebaker Family Practice Inc.
• Jeffrey Bruce Studebaker, M.D.

• Family Medicine Physician in Brookville, OH
• Providers in Brookville, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.