Individual provider Active NPI

Melissa Rae Good

  • Nurse Practitioner
  • Ocala, FL
National Provider Identifier
1407496953
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11005710 Issued in FL
Practice address
6160 SW State Road 200 # 119
Ocala, FL 34476-8307
Phone
(352) 233-4178
NPI assigned
Jan 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2020

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 11005710 FL Primary

Addresses

Primary practice location

6160 SW State Road 200 # 119
Ocala, FL 34476-8307

Mailing address

6160 SW State Road 200 # 119
Ocala, FL 34476-8307

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20211111002822 FL Practitioner - Nurse Practitioner 0547659500 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11005710FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of Central Florida LLP CurrentSince Nov 1, 2021 Accepting new patients

Locations

1900 Don Wickham Dr
Clermont, FL 34711
Phone (352) 536-8761

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

1414 S Orange Ave
#112
Orlando, FL 32806
Phone (407) 767-1200

Organizations & group practices 1

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": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1407496953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6160 SW STATE ROAD 200 # 119",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344768307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6160 SW STATE ROAD 200 # 119",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344768307",
            "telephone_number": "352-233-4178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOD",
        "first_name": "MELISSA",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-13",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11005710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

Verify at the official NPI Registry.