Individual provider Active NPI

Melody Kay Willis, MSN, RN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Crystal Cty, MO
National Provider Identifier
1336604370
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2019009372 Issued in MO
Practice address
1420 US Highway 61
Crystal Cty, MO 63028-4108
Phone
(636) 543-2230
Fax
(636) 543-2231
NPI assigned
Feb 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2019009372 MO Primary

Addresses

Primary practice location

1420 US Highway 61
Crystal Cty, MO 63028-4108

Mailing address

1420 US Highway 61
Crystal Cty, MO 63028-4108
Phone (636) 543-2230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20190826001874 MO Practitioner - Nurse Practitioner 3375871510 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Adult Hospitalists Jefferson LLCGroup PAC ID 8628205598, 58 clinicians
Mercy Aco Clinical Services IncGroup PAC ID 6901188572, 159 clinicians
Mercy Clinic Adult Hospitalists - Washington, LLCGroup PAC ID 3577630540, 31 clinicians

Practice addresses (Care Compare)

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1899

10018 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-3423

1400 US Hwy 61
Festus, MO 63028-4100
Phone (636) 933-8091

15740 S Outer 40 Rd
Chesterfield, MO 63017-2004
Phone (636) 237-4200

851 E 5TH St
Suite 154
Washington, MO 63090-3136
Phone (636) 239-8677

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
2018089610MOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Adult Hospitalists - Washington, LLC CurrentSince Jul 1, 2020 Accepting new patients
Mercy Aco Clinical Services Inc CurrentSince Jul 11, 2022 Accepting new patients
St Anthonys Physician Organization Hospitalist Services, L.C. CurrentSince Jul 1, 2020 Accepting new patients
Mercy Clinic Adult Hospitalists - St. Louis, LLC CurrentSince Jul 1, 2020 Accepting new patients
Mercy Clinic Adult Hospitalists- Jefferson, LLC CurrentSince Jul 1, 2020 Accepting new patients
Mercy East Support Services, LLC CurrentSince Jun 22, 2019 Accepting new patients

Locations

15740 South Outer 40 Rd
Chesterfield, MO 63017
Phone (636) 735-4268

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

615 S New Ballas Rd
#H
Saint Louis, MO 63141
Phone (314) 251-6075

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

851 E 5th St
Ste 154
Washington, MO 63090
Phone (314) 251-6663

901 Patients First Dr
Washington, MO 63090
Phone (636) 239-7500

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

Interoperability endpoints

  • Direct secure messaging: mwillis1027028@directc.mercy.net

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1549238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1336604370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 US HIGHWAY 61",
            "city": "CRYSTAL CTY",
            "state": "MO",
            "postal_code": "630284108",
            "telephone_number": "636-543-2230",
            "fax_number": "636-543-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 US HIGHWAY 61",
            "city": "CRYSTAL CTY",
            "state": "MO",
            "postal_code": "630284108",
            "telephone_number": "636-543-2230",
            "fax_number": "636-543-2231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "MELODY",
        "middle_name": "KAY",
        "credential": "MSN, RN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-04",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2019009372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Cty, MO

Sources for this page

Verify at the official NPI Registry.