NPIMap

Individual provider Active NPI

Melanie Halvorson, M.D.

  • Nephrology Physician
  • Montgomery, AL
National Provider Identifier
1265438527
Registry record updated Feb 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
00019879 Issued in AL
Practice address
4760 Woodmere Blvd
Montgomery, AL 36106-3065
Phone
(334) 288-0814
Fax
(334) 288-3417
NPI assigned
Jun 22, 2005
Last updated
Feb 19, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 00019879 AL Primary

Addresses

Primary practice location

4760 Woodmere Blvd
Montgomery, AL 36106-3065

Mailing address

4760 Woodmere Blvd
Montgomery, AL 36106-3065
Phone (334) 288-0814

Other identifiers 9

IdentifierTypeStateIssuer
000033781MedicaidAL
000040637MedicaidAL
390004990OtherRAILROAD MEDICARE
51033782HALOtherBCBS OF ALABAMA
51033781HALOtherBCBS OF ALABAMA
000033782MedicaidAL
51040637HALOtherBCBS OF ALABAMA
F49427OtherHEALTH SPRINGS
3110016OtherUNITED HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20090716000311 AL Practitioner - NephrologyPractitioner - Internal Medicine 8224116827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of Alabama School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Renal Associates of Montgomery, P.C.Group PAC ID 6608894019, 9 clinicians

Practice addresses (Care Compare)

1412 Elba Hwy
Troy, AL 36079-6020
Phone (334) 288-0814

44 Medical Arts CT
Greenville, AL 36037-3869
Phone (334) 288-0814

4760 Woodmere Blvd
Montgomery, AL 36106-3065
Phone (334) 288-0814

556 McQueen Smith Rd N
Prattville, AL 36066-5558
Phone (334) 288-0814

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19879ALMDPharmacist
00019879ALMDNephrology Physician

Interoperability endpoints

  • Direct secure messaging: melanie.halvorson@direct.baptistfirst.org
  • Direct secure messaging: melanie.halvorson@ram.eclinicaldirectplus.com

Organizations & group practices 1

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 9

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266537600000",
    "number": "1265438527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 WOODMERE BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361063065",
            "telephone_number": "334-288-0814",
            "fax_number": "334-288-3417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 WOODMERE BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361063065",
            "telephone_number": "334-288-0814",
            "fax_number": "334-288-3417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALVORSON",
        "first_name": "MELANIE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2010-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AL",
            "license": "00019879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000033781",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000040637",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "390004990",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "51033782HAL",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "51033781HAL",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000033782",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "51040637HAL",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH SPRINGS",
            "identifier": "F49427",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH",
            "identifier": "3110016",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.