Jennifer Elizabeth Mellott, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R173365 Issued in MD

Practice address

25701 Shady LN SW
Westernport, MD 21562-2017

Phone

(301) 359-3000

NPI assigned

Feb 1, 2022

Last updated

Feb 1, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellcare IncGroup PAC ID 5799171450, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Western Maryland Regional Medical Center Hospital, Cumberland, MD, CCN 210027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Wellcare Inc

  • Family Medicine Physician
  • Lavale, MD
  • NPI 1912667734
  Medicare reassignment Care Compare group NPD
• CNP Operating Co LLC

  • Multi-Specialty Clinic/Center
  • Salisbury, MD
  • NPI 1518386739
  Medicare reassignment NPD
• PA Post Acute Services PC

  • General Practice Physician
  • Masury, OH
  • NPI 1255057063

  MD

  Medicare reassignment NPD
• Premier NP Clinical Consulting LLC

  • Family Medicine Physician
  • Cumberland, MD
  • NPI 1942133145
  NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Upmc Western Maryland Corporation

  dba Upmc Western Maryland Center for Hope and Healing

  • Mental Illness Community Based Residential Treatment Facility
  • Cumberland, MD
  • NPI 1174141592

  Hospital

  Care Compare affiliation
• Upmc Western Maryland Corporation

  dba UPMC Western Maryland

  • General Acute Care Hospital
  • Cumberland, MD
  • NPI 1609831247
  Care Compare affiliation
• Upmc Western Maryland Corporation

  dba UPMC Western Maryland

  • Hearing and Speech Clinic/Center
  • Cumberland, MD
  • NPI 1740969245

  Hospital

  Care Compare affiliation
• Upmc Western Maryland Corporation

  dba UPMC Western Maryland

  • Clinic/Center
  • Cumberland, MD
  • NPI 1780251850

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1538812482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 ELKRIDGE LANDING RD STE 300",
            "city": "LINTHICUM HEIGHTS",
            "state": "MD",
            "postal_code": "210902958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25701 SHADY LN SW",
            "city": "WESTERNPORT",
            "state": "MD",
            "postal_code": "215622017",
            "telephone_number": "301-359-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLOTT",
        "first_name": "JENNIFER",
        "middle_name": "ELIZABETH",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-01",
        "last_updated": "2022-02-01",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R173365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanna Kyle
• James A Lauder, PT
• Lacey Lee, FNP-C
• Madison Llewellyn, PHARMD
• Kimberly Sue Maynard, CRNP-F
• Moran Manor Nursing and Rehabilitation Center, LLC
• Moran Manor, LP (Moran Manor Health Care Center)
• Connie Sue Morgan
• Swetha Nimmala, PT
• Norris Counseling Services (Appalachian Behavioral Health Center)

• Family Nurse Practitioner in Westernport, MD
• Providers in Westernport, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.