Individual provider Active NPI

Melissa Larson, FNP

  • Nurse Practitioner
  • Goshen, IN
National Provider Identifier
1336625409
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71008356A Issued in IN
Practice address
1615 Winsted Dr Ste 1
Goshen, IN 46526-4673
Phone
(574) 537-1625
NPI assigned
Jul 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71008356A IN Primary

Addresses

Primary practice location

1615 Winsted Dr Ste 1
Goshen, IN 46526-4673

Mailing address

1615 Winsted Dr Ste 1
Goshen, IN 46526-4673

Other identifiers 1

IdentifierTypeStateIssuer
300019082MedicaidIN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address melissa.larsonnp.p1@direct.goshenphysicians.nextgenshare.com Health Information Exchange (HIE)
Direct Messaging Address melissa.larson@goshenhealthdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20181004000479 IN Practitioner - Nurse Practitioner 6901158831 Reassigns benefits to 1 organization

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
Goshen Health System IncGroup PAC ID 4880598572, 135 clinicians

Practice addresses (Care Compare)

1033 N Indiana Ave
Syracuse, IN 46567-1017
Phone (574) 457-5701

1615 Winsted Dr
Goshen, IN 46526-4673

200 High Park Ave
Goshen, IN 46526-4810
Phone (574) 364-2888

2824 Elkhart Rd
Goshen, IN 46526-1014
Phone (574) 535-1700

2832 Elkhart Rd
Goshen, IN 46526-1014
Phone (574) 537-0219

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71008356AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Goshen Health System Inc Nurse Practitioner CurrentSince Nov 1, 2018 Accepting new patients
Goshen Health System Inc CurrentSince Nov 1, 2018 Accepting new patients
Goshen Hospital Association Inc Current Accepting new patients

Locations

851 Parkway Ave
Elkhart, IN 46516
Phone (574) 364-2875

1615 Winsted Dr
Ste 2
Goshen, IN 46526
Phone (574) 533-0300

1615 Winsted Dr
Ste 1
Goshen, IN 46526
Phone (574) 293-3545

2824 Elkhart Rd
Goshen, IN 46526
Phone (574) 534-6752

1615 Winsted Dr
Ste 4
Goshen, IN 46526
Phone (574) 533-8420

1033 N Indiana Ave
Syracuse, IN 46567
Phone (574) 457-5701

Organizations & group practices 3

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 1

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": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1336625409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 WINSTED DR STE 1",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465264673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 WINSTED DR STE 1",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465264673",
            "telephone_number": "574-537-1625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "MELISSA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71008356A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300019082",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "melissa.larsonnp.p1@direct.goshenphysicians.nextgenshare.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1615 Winsted Dr Ste 1",
            "city": "Goshen",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465264673",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "melissa.larson@goshenhealthdirect.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1615 Winsted Dr Ste 1",
            "city": "Goshen",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465264673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Goshen, IN

Sources for this page

Verify at the official NPI Registry.