Individual provider Active NPI

Melissa Anne Cousins, FNP

  • Family Nurse Practitioner
  • Anderson, IN
National Provider Identifier
1396821724
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71002237A Issued in IN
Practice address
2009 Brown St
Anderson, IN 46016-4216
Phone
(317) 574-1254
Fax
(317) 674-0060
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5004311 NC
Family Nurse Practitioner 363LF0000X 5004311 NC
Family Nurse Practitioner 363LF0000X 71002237A IN Primary

Addresses

Primary practice location

2009 Brown St
Anderson, IN 46016-4216

Mailing address

6807 Rustic Wood CT
Pleasant Garden, NC 27313-9567
Phone (317) 574-1254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, OH2 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
I20210802001133 IN Practitioner - Nurse Practitioner 0840284899 Reassigns benefits to 1 organization
I20251016001439 OH Practitioner - Nurse Practitioner 0840284899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Physicians IncGroup PAC ID 0840104360, 314 clinicians

Practice addresses (Care Compare)

540 Lincoln Park Blvd
Suite 200
Kettering, OH 45429-6403
Phone (937) 293-1117

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71002237AINMDFamily Nurse Practitioner
5004311NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physicians Inc CurrentSince Nov 10, 2025 Accepting new patients
Alliance Physicians Inc CurrentSince Nov 10, 2025 Accepting new patients
Ameri-Care Family Practice Past Accepting new patients
Randolph Specialty Group Practice Past Accepting new patients

Locations

540 Lincoln Park Blvd
Ste 200
Kettering, OH 45429
Phone (937) 293-1117

1625 S Alex Rd
West Carrollton, OH 45449
Phone (937) 865-0534

Organizations & group practices 5

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1396821724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6807 RUSTIC WOOD CT",
            "city": "PLEASANT GARDEN",
            "state": "NC",
            "postal_code": "273139567",
            "telephone_number": "317-574-1254",
            "fax_number": "828-808-2793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2009 BROWN ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460164216",
            "telephone_number": "317-574-1254",
            "fax_number": "317-674-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUSINS",
        "first_name": "MELISSA",
        "middle_name": "ANNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2025-07-02",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5004311",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5004311",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71002237A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

Verify at the official NPI Registry.