Individual provider Active NPI

Melanie Larson, DNP, RN, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Midland, TX
National Provider Identifier
1548842453
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1033174 Issued in TX
Practice address
2002 N Midland Dr
Midland, TX 79707-5598
Phone
(432) 614-0350
NPI assigned
Apr 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1033174 TX Primary

Addresses

Primary practice location

2002 N Midland Dr
Midland, TX 79707-5598

Mailing address

2002 N Midland Dr
Midland, TX 79707-5598
Phone (432) 614-0350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20211007000404 TX Practitioner - Nurse Practitioner 2668546110 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1033174TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vikram Vadyala PLLC CurrentSince Nov 27, 2023 Accepting new patients
Recovery and Goals PLLC CurrentSince Nov 27, 2023 Accepting new patients

Locations

2002 N Midland Dr
Midland, TX 79707
Phone (432) 614-0350

Interoperability endpoints

  • Direct secure messaging: melanie.jones@1908.securemail.prognocis.com
  • FHIR API: https://api.platform.athenahealth.com/16715/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1548842453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 N MIDLAND DR",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797075598",
            "telephone_number": "432-614-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 N MIDLAND DR",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797075598",
            "telephone_number": "432-614-0350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "MELANIE",
        "credential": "DNP, RN, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-21",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1033174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, TX

Sources for this page

Verify at the official NPI Registry.