Individual provider Active NPI

Melissa Kay Lagrange, CNP

  • Family Nurse Practitioner
  • Perrysburg, OH
National Provider Identifier
1508403304
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.026003 Issued in OH
Practice address
1601 Brigham Dr Ste 200
Perrysburg, OH 43551-7117
Phone
(567) 585-0380
Fax
(567) 585-0381
NPI assigned
Nov 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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 APRN.CNP.026003 OH Primary

Addresses

Primary practice location

1601 Brigham Dr Ste 200
Perrysburg, OH 43551-7117

Mailing address

5175 Levi'S Commons Blvd
Suite 104
Perrysburg, OH 43551
Phone (567) 585-0380

Other practice location 1

3156 Dustin Rd Ste 300
Oregon, OH 43616-4300
Phone (567) 585-0496

Other identifiers 1

IdentifierTypeStateIssuer
APRN.CNP.026003OtherOHOHIO BOARD OF NURSING

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mlagrange192490@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20200408001804 OH Practitioner - Nurse Practitioner 8729417027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Multi Specialty PhysiciansGroup PAC ID 7113182809, 269 clinicians

Practice addresses (Care Compare)

1601 Brigham Dr
Suite 200
Perrysburg, OH 43551-7117
Phone (567) 585-0380

Hospital & facility affiliations

  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068
  • Bay Park Community Hospital Hospital, Oregon, OH, CCN 360259

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: mlagrange192490@direct.promedica.org

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.

Hospital & facility affiliations 3

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": "1575072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1508403304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5175 LEVI'S COMMONS BLVD",
            "address_2": "SUITE 104",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "43551",
            "telephone_number": "567-585-0380",
            "fax_number": "567-585-0381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 BRIGHAM DR STE 200",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435517117",
            "telephone_number": "567-585-0380",
            "fax_number": "567-585-0381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3156 Dustin Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Oregon",
            "state": "OH",
            "postal_code": "436164300",
            "country_code": "US",
            "telephone_number": "567-585-0496",
            "fax_number": "567-585-0661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAGRANGE",
        "first_name": "MELISSA",
        "middle_name": "KAY",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-30",
        "last_updated": "2023-11-03",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.026003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO BOARD OF NURSING",
            "identifier": "APRN.CNP.026003",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlagrange192490@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

Verify at the official NPI Registry.