Individual provider Active NPI

Melanie Rose Wilkes, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Santa Fe, NM
National Provider Identifier
1467959023
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
66689 Issued in NM
Practice address
2052 Galisteo St
Santa Fe, NM 87505-2100
Phone
(505) 819-3419
NPI assigned
Apr 10, 2018
Last updated
Jul 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN-78118 NM
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 66689 NM Primary

Addresses

Primary practice location

2052 Galisteo St
Santa Fe, NM 87505-2100

Mailing address

2228 Calle Cacique
Santa Fe, NM 87505-4903

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20220308003072 NM Practitioner - Nurse Practitioner 4981098951 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN-78118NMMDRegistered Nurse
66689NMMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Healthcare Services, Inc. CurrentSince Aug 19, 2024 Accepting new patients
Behavioral Healthcare Services, Inc. CurrentSince Aug 19, 2024 Accepting new patients
Healthier You, LLC Psychiatric/Mental Health PastSince Oct 27, 2024 Accepting new patients

Locations

707 Broadway Blvd NE
Ste 500
Albuquerque, NM 87102
Phone (505) 248-2726

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1467959023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2228 CALLE CACIQUE",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2052 GALISTEO ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875052100",
            "telephone_number": "505-819-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKES",
        "first_name": "MELANIE",
        "middle_name": "ROSE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-10",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "RN-78118",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "66689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.