Individual provider Active NPI

Melissa Meagan States, APRN-CNP

  • Family Nurse Practitioner
  • Kingfisher, OK
National Provider Identifier
1427367804
Registry record updated Apr 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0071397 Issued in OK
Practice address
1610 S Main St
Kingfisher, OK 73750-4600
Phone
(405) 375-5222
Fax
(405) 375-5234
NPI assigned
Oct 1, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R0071397 OK Primary

Addresses

Primary practice location

1610 S Main St
Kingfisher, OK 73750-4600

Mailing address

1610 S Main St
Kingfisher, OK 73750-4600
Phone (405) 375-5222

Other identifiers 1

IdentifierTypeStateIssuer
200318780AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20110531000394 OK Practitioner - Nurse Practitioner 2466639489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1610 S Main St
Kingfisher, OK 73750-4600
Phone (405) 375-5222

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0071397OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Physician Services LLC Past Accepting new patients
Summit Medical Center Past Accepting new patients

Organizations & group practices 3

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": "1285891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366156800000",
    "number": "1427367804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 S MAIN ST",
            "city": "KINGFISHER",
            "state": "OK",
            "postal_code": "737504600",
            "telephone_number": "405-375-5222",
            "fax_number": "405-375-5234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 S MAIN ST",
            "city": "KINGFISHER",
            "state": "OK",
            "postal_code": "737504600",
            "telephone_number": "405-375-5222",
            "fax_number": "405-375-5234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATES",
        "first_name": "MELISSA",
        "middle_name": "MEAGAN",
        "name_prefix": "Mrs.",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-01",
        "last_updated": "2013-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0071397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200318780A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingfisher, OK

Sources for this page

Verify at the official NPI Registry.