NPIMap

Individual provider Active NPI

Melissa Marie Davis, CNP

  • Family Nurse Practitioner
  • Plankinton, SD
National Provider Identifier
1508020827
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CP000552 Issued in SD
Practice address
104 W Commerce St
Plankinton, SD 57368
Phone
(605) 299-8234
Fax
(605) 799-1165
NPI assigned
Jul 16, 2008
Last updated
May 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R1489646 MN
Family Nurse Practitioner 363LF0000X CP000552 SD Primary

Addresses

Primary practice location

104 W Commerce St
Plankinton, SD 57368

Mailing address

PO Box 35
Plankinton, SD 57368-0035
Phone (605) 299-8234

Other names 1

  • Melissa M Staller Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090527000145 SD Practitioner - Nurse Practitioner 6204983414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hometown Family Health PLLCGroup PAC ID 4284019381, 3 clinicians

Practice addresses (Care Compare)

104 W Commerce St
Plankinton, SD 57368-2083
Phone (605) 299-8234

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hometown Family Health PLLC Family CurrentSince Jul 4, 2022 Accepting new patients
Aurora Plains Academy LLC Past Accepting new patients
Aurora Brule Nursing Home, Inc. PastSince Jul 4, 2022 Accepting new patients

Locations

408 S Johnston St
White Lake, SD 57383
Phone (605) 249-2216

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26394/brand/1/csg/1/fhir/r4
  • Direct secure messaging: melissa.davis.1@26394.direct.athenahealth.com

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.

Hospital & facility affiliations 8

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": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1508020827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35",
            "city": "PLANKINTON",
            "state": "SD",
            "postal_code": "573680035",
            "telephone_number": "605-299-8234",
            "fax_number": "605-799-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W COMMERCE ST",
            "city": "PLANKINTON",
            "state": "SD",
            "postal_code": "57368",
            "telephone_number": "605-299-8234",
            "fax_number": "605-799-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-16",
        "last_updated": "2022-05-16",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R1489646",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP000552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "STALLER",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Plankinton, SD

Sources for this page

Verify at the official NPI Registry.