Individual provider Active NPI

Melissa Marie Outman, FNP

  • Family Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1326519950
Registry record updated Dec 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704284313 Issued in MI
Practice address
3322 E Beltline CT NE
Grand Rapids, MI 49525-9480
Phone
(616) 226-2669
NPI assigned
Dec 7, 2018
Last updated
Dec 7, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704284313 MI Primary

Addresses

Primary practice location

3322 E Beltline CT NE
Grand Rapids, MI 49525-9480

Mailing address

14215 28TH St
Lowell, MI 49331-8658
Phone (301) 356-4713

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20201012002638 MI Practitioner - Nurse Practitioner 1355761412 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Wound Care of Caro PCGroup PAC ID 3678926227, 6 clinicians
Promed Preferred Mi 2 PLLCGroup PAC ID 0345779369, 9 clinicians

Practice addresses (Care Compare)

1800 W Caro Rd
Suite 12
Caro, MI 48723-8209
Phone (488) 947-0242

26090 Lannys Rd
Novi, MI 48375-1022
Phone (501) 229-5803

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704284313MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Health Care PC CurrentSince Jun 10, 2023 Accepting new patients
West Michigan Pain Center PC CurrentSince Oct 1, 2024 Accepting new patients
Samaritan Health Care, PC CurrentSince Jun 10, 2023 Accepting new patients
Theoria Medical Nurse Practitioner CurrentSince Mar 1, 2020 Accepting new patients
Advanced Wound Care of Caro PC Nurse Practitioner CurrentSince Jan 4, 2025 Accepting new patients
Advanced Wound Care Specialists PC Nurse Practitioner CurrentSince Dec 20, 2025 Accepting new patients
Wellbridge of Clarkston, LLC Past Accepting new patients

Locations

1800 W Caro Rd
Caro, MI 48723
Phone (989) 589-0069

1800 W Caro Rd
Ste 12
Caro, MI 48723
Phone (248) 894-7024

5655 Clarkston Rd
Clarkston, MI 48348
Phone (810) 623-5216

3139 E Baldwin Rd
Grand Blanc, MI 48439
Phone (810) 445-5300

4024 Park East Ct SE
Grand Rapids, MI 49546
Phone (231) 592-3102

811 E Kent Rd
Greenville, MI 48838
Phone (616) 225-0202

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

Organizations & group practices 7

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": "1544140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544140800000",
    "number": "1326519950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14215 28TH ST",
            "city": "LOWELL",
            "state": "MI",
            "postal_code": "493318658",
            "telephone_number": "301-356-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3322 E BELTLINE CT NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259480",
            "telephone_number": "616-226-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUTMAN",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-07",
        "last_updated": "2018-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704284313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.