Individual provider Active NPI

Melaynia Sapp, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Chubbuck, ID
National Provider Identifier
1275379968
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2071150 Issued in ID
Practice address
4650 Hawthorne Rd Ste 3B
Chubbuck, ID 83202-2376
Phone
(208) 252-5621
NPI assigned
Jul 2, 2024
Last updated
May 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2071150 ID Primary
General Practice Registered Nurse 163WG0000X 62272 ID

Addresses

Primary practice location

4650 Hawthorne Rd Ste 3B
Chubbuck, ID 83202-2376

Mailing address

4650 Hawthorne Rd Ste 3B
Chubbuck, ID 83202-2376
Phone (208) 252-5621

Other practice location 1

3305 E Sunnyside Rd
Ammon, ID 83406-7719
Phone (262) 470-6108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20250818003838 ID Practitioner - Nurse Practitioner 9032618962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Canvi Behavioral Health PLLCGroup PAC ID 0941692073, 14 clinicians

Practice addresses (Care Compare)

4650 Hawthorne Rd
Suite 3B
Chubbuck, ID 83202-2376
Phone (208) 252-5621

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2071150IDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Canvi Behavioral Health PLLC Psychiatric/Mental Health CurrentSince Jun 5, 2025 Accepting new patients

Locations

427 N Main St
Ste 103
Pocatello, ID 83204
Phone (208) 595-7966

4650 Hawthorne Rd
Ste 3B
Pocatello, ID 83202
Phone (208) 237-9833

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.

NPI Registry JSON

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

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1275379968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 HAWTHORNE RD STE 3B",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022376",
            "telephone_number": "208-252-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 HAWTHORNE RD STE 3B",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022376",
            "telephone_number": "208-252-5621"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3305 E Sunnyside Rd",
            "address_purpose": "LOCATION",
            "city": "Ammon",
            "state": "ID",
            "postal_code": "834067719",
            "country_code": "US",
            "telephone_number": "262-470-6108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAPP",
        "first_name": "MELAYNIA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-02",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "2071150",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "ID",
            "license": "62272",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chubbuck, ID

Sources for this page

Verify at the official NPI Registry.