Individual provider Active NPI

Melissa Rose Mutch, CPNP-PC

  • Pediatric Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1396411476
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN.CNP.0028638 Issued in OH
Practice address
700 Childrens Dr
Columbus, OH 43205-2639
Phone
(614) 722-2000
NPI assigned
Aug 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APRN.CNP.0028638 OH Primary

Addresses

Primary practice location

700 Childrens Dr
Columbus, OH 43205-2639

Mailing address

700 Childrens Dr
Columbus, OH 43205-2664
Phone (614) 722-2000

Other identifiers 1

IdentifierTypeStateIssuer
0466329MedicaidOH

Other names 1

  • Melissa Rose Cameron Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20211109002222 OH Practitioner - Nurse Practitioner 4587053772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Children'S Anesthesia Associates IncGroup PAC ID 4587568993, 89 clinicians

Practice addresses (Care Compare)

700 Children'S Dr
Columbus, OH 43205-2664
Phone (614) 722-6158

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0028638OHMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Anesthesia Associates Inc Pediatrics CurrentSince Nov 15, 2021 Accepting new patients
Nationwide Children'S Hospital Past Accepting new patients

Locations

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

Organizations & group practices 2

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": "1629331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1396411476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052639",
            "telephone_number": "614-722-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTCH",
        "first_name": "MELISSA",
        "middle_name": "ROSE",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-19",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "APRN.CNP.0028638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0466329",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "CAMERON",
            "middle_name": "ROSE",
            "credential": "CPNP-PC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.