Melanie Amanda Ellis, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

17426-33 Issued in WI

Practice address

PO Box 97
Green Lake, WI 54941-0097

Phone

(920) 229-0686

NPI assigned

Sep 13, 2025

Last updated

Sep 13, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• McArthur Gruff & Associates LLC

  dba Visionary Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Hillsboro, OR
  • NPI 1952860066
  Medicare reassignment

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

{
    "created_epoch": "1757721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757721600000",
    "number": "1376414466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97",
            "city": "GREEN LAKE",
            "state": "WI",
            "postal_code": "549410097",
            "telephone_number": "920-229-0686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 97",
            "city": "GREEN LAKE",
            "state": "WI",
            "postal_code": "549410097",
            "telephone_number": "920-229-0686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "MELANIE",
        "middle_name": "AMANDA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-13",
        "last_updated": "2025-09-13",
        "certification_date": "2025-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "17426-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Community Options, Inc.
• County of Green Lake (Green Lake County DHHS)
• County of Green Lake (Green Lake County DHHS)
• Shirley J. Dawson, M.D.
• Holley Dornfeld, SAC-IT
• Nancy Jean Gimenez, RN, BSN, MS
• Green Lake County Senior Transportation, Inc
• Green Lake Medical Clinic
• Green Lake Medical Clinic , S.C.
• Green Lake School District

• Psychiatric/Mental Health Nurse Practitioner in Green Lake, WI
• Providers in Green Lake, WI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.