Individual provider Active NPI

Melissa A. Kelly, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1487122784
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2018039451 Issued in MO
Practice address
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone
(314) 251-6339
NPI assigned
Nov 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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 2018039451 MO Primary

Addresses

Primary practice location

615 S New Ballas Rd
Saint Louis, MO 63141-8221

Mailing address

621 S New Ballas Rd Ste 112a
Saint Louis, MO 63141-8252
Phone (314) 251-6339

Other practice location 1

15740 S Outer 40 Rd
Chesterfield, MO 63017-2004
Phone (636) 237-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20190211000574 MO Practitioner - Nurse Practitioner 3870830748 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Aco Clinical Services IncGroup PAC ID 6901188572, 159 clinicians
Western Anesthesiology Associates IncGroup PAC ID 6204720667, 251 clinicians

Practice addresses (Care Compare)

15740 S Outer 40 Rd
Chesterfield, MO 63017-2004
Phone (636) 237-4200

615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (314) 251-4687

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2018039451MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities CurrentSince Sep 14, 2019 Accepting new patients
Mercy Aco Clinical Services Inc CurrentSince Mar 7, 2020 Accepting new patients
Mercy Clinic Adult Hospitalists - St. Louis, LLC CurrentSince Oct 27, 2024 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Jan 6, 2019 Accepting new patients
Western Anesthesiology Associates, Inc. CurrentSince Apr 25, 2023 Accepting new patients

Locations

339 Consort Dr
Ballwin, MO 63011
Phone (636) 386-7222

15740 South Outer 40 Rd
Chesterfield, MO 63017
Phone (636) 735-4268

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 110
Rolla, MO 65401
Phone (573) 458-6300

615 S New Ballas Rd
#H
Saint Louis, MO 63141
Phone (314) 251-6075

621 S New Ballas Rd
Ste 112A
Saint Louis, MO 63141
Phone (314) 251-6339

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

621 S New Ballas Rd
Ste 399A
Saint Louis, MO 63141
Phone (314) 251-1820

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

Organizations & group practices 6

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 2

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": "1541376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1487122784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 112A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418252",
            "telephone_number": "314-251-6339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-6339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15740 S Outer 40 Rd",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630172004",
            "country_code": "US",
            "telephone_number": "636-237-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MELISSA",
        "middle_name": "A.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-05",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2018039451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.