Melissa Jane Wilson, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

23186 Issued in TN

Practice address

110 Executive Park Dr
Clinton, TN 37716-6876

Phone

(865) 494-9241

Fax

(865) 374-2121

NPI assigned

Sep 28, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Melissa Jane Hull Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN, KY2 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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Medical Center of Oak Ridge Hospital, Oak Ridge, TN, CCN 440034
• Parkwest Medical Center Hospital, Knoxville, TN, CCN 440173

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wilson.melissa@covenanthealth.cernerdirect.com

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.

• Covenant Medical Group, Inc.

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1457302010
  Medicare reassignment Care Compare group NPD
• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Spring Hill, TN
  • NPI 1134452865
  Medicare reassignment NPD
• Summit Medical Group, PLLC

  • Internal Medicine Physician
  • Brentwood, TN
  • NPI 1659090298
  Medicare reassignment NPD
• Midwest Home Physicians Inc

  • Multi-Specialty Clinic/Center
  • Cleveland, OH
  • NPI 1760086540

  TN

  Medicare reassignment NPD
• Hoover A Perry, MD

  • General Practice Physician
  • Whitley City, KY
  • NPI 1649236613
  Medicare reassignment
• Covenant Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Knoxville, TN
  • NPI 1871269415
  NPD
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  NPD
• Summit Medical Group, PLLC

  • Family Medicine Physician
  • Powell, TN
  • NPI 1740351196
  NPD
• Crossville Medical Group PA

  • Multi-Specialty Clinic/Center
  • Crossville, TN
  • NPI 1053414698
  NPD (past)

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

• Methodist Medical Center

  • General Acute Care Hospital
  • Oak Ridge, TN
  • NPI 1700870672
  Care Compare affiliation
• Parkwest Medical Center

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1396739165
  Care Compare affiliation

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

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1265941694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 EXECUTIVE PARK DR",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "377166876",
            "telephone_number": "865-494-9241",
            "fax_number": "865-374-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 EXECUTIVE PARK DR",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "377166876",
            "telephone_number": "865-494-9241",
            "fax_number": "865-374-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1038 Jurgens Rd.",
            "address_purpose": "LOCATION",
            "city": "Robbins",
            "state": "TN",
            "postal_code": "37852",
            "country_code": "US",
            "telephone_number": "724-970-4453",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 N Highway 27",
            "address_purpose": "LOCATION",
            "city": "Whitley City",
            "state": "KY",
            "postal_code": "426536024",
            "country_code": "US",
            "telephone_number": "606-376-5363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MELISSA",
        "middle_name": "JANE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-28",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3012980",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "23186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q044813",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Wilson.melissa@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "110 Executive Park Dr",
            "city": "Clinton",
            "state": "TN",
            "country_code": "US",
            "postal_code": "377166876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "HULL",
            "middle_name": "JANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jenny Elizabeth Welch, FNP-BC
• Karen R Whalen, APRN, BC
• Nicka S. Wheat, COTA
• Wesley Whisenant, DDS
• Kellye Watkins Wilson, RDH
• Elizabeth Ann Wishart, FNP-BC
• Woodland Post Acute LLC
• Samantha Michelle Woods, BSN, RN
• Mollie Katherine Wright, PHARM. D.
• Savannah Wright

• Nurse Practitioner in Clinton, TN
• Providers in Clinton, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.