Individual provider Active NPI

Melissa Spencer Marshall, ARNP

  • Nurse Practitioner
  • Council Bluffs, IA
National Provider Identifier
1356690887
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A105753 Issued in IA
Practice address
1001 Risen Son Blvd
Council Bluffs, IA 51503-1910
Phone
(712) 256-8600
Fax
(712) 256-8599
NPI assigned
Aug 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 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 A105753 IA Primary

Addresses

Primary practice location

1001 Risen Son Blvd
Council Bluffs, IA 51503-1910

Mailing address

PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, NE2 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

Enrollment IDStateProvider typePAC IDDetails
I20130109000695 IA Practitioner - Nurse Practitioner 7012160682 Reassigns benefits to 4 organizations
I20211230001069 NE Practitioner - Nurse Practitioner 7012160682 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shenandoah Medical Center Current Accepting new patients
All Care Health Center CurrentSince Aug 1, 2022 Accepting new patients
Physicians Clinic Inc Nurse Practitioner CurrentSince Nov 30, 2023 Accepting new patients
Shenandoah Medical Center CurrentSince Nov 1, 2015 Accepting new patients
Shenandoah Medical Center CurrentSince Nov 1, 2015 Accepting new patients
Clarinda Regional Health Center CurrentSince Jan 5, 2015 Accepting new patients
Nebraska Methodist Hospital Current Accepting new patients
All Care Health Center CurrentSince Aug 1, 2022 Accepting new patients
Infinite Medical PC Nurse Practitioner CurrentSince Oct 1, 2021 Accepting new patients

Locations

220 Essie Davison Dr
Clarinda, IA 51632
Phone (712) 542-8330

1 Edmundson Pl
Ste 310
Council Bluffs, IA 51503
Phone (712) 328-1801

1 Edmundson Pl
Council Bluffs, IA 51503
Phone (712) 396-4000

1001 Risen Son Blvd
Council Bluffs, IA 51503
Phone (712) 256-8591

902 S 6th St
Rm A
Council Bluffs, IA 51501

902 S 6th St
Council Bluffs, IA 51501
Phone (712) 256-6583

320 Ebaugh St
Glenwood, IA 51534
Phone (712) 527-5204

300 Pershing Ave
Shenandoah, IA 51601
Phone (712) 246-1230

1 Jack Foster Dr
Shenandoah, IA 51601
Phone (712) 246-7240

2855 40th Ave
Columbus, NE 68601
Phone (402) 563-8014

318 W 18th St
#1110
Cozad, NE 69130

1405 W US Highway 34
Grand Island, NE 68801
Phone (308) 382-6394

825 S 169th St
Fl 3
Omaha, NE 68118
Phone (402) 354-5451

5505 Grover St
Omaha, NE 68106
Phone (402) 558-0225

250 Skillman St
Ste 202
Brooklyn, NY 11205

Interoperability endpoints

  • Direct secure messaging: melissa.marshall@direct.nmhs.org
  • FHIR API: https://webprd.ochin.org/prd-fhir/allcarehealthcenter/api/FHIR/R4

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1346284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1356690887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 RISEN SON BLVD",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515031910",
            "telephone_number": "712-256-8600",
            "fax_number": "712-256-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "MELISSA",
        "middle_name": "SPENCER",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-30",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A105753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

Verify at the official NPI Registry.