Individual provider Active NPI

Melonie K. Rockwell, A.R.N.P.

  • Adult Health Nurse Practitioner
  • Olympia, WA
National Provider Identifier
1558427732
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP30000813 Issued in WA
Practice address
1011 10TH Ave SE
Olympia, WA 98501-1566
Phone
(350) 349-0033
NPI assigned
Dec 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN00064971 WA
Adult Health Nurse Practitioner 363LA2200X AP30000813 WA Primary

Addresses

Primary practice location

1011 10TH Ave SE
Olympia, WA 98501-1566

Mailing address

PO Box 34584
Seattle, WA 98124-1584
Phone (509) 241-7349

Other identifiers 1

IdentifierTypeStateIssuer
9627761MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20080131000159 WA Practitioner - Nurse Practitioner 9234211137 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN00064971WAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 1, 1998 Accepting new patients
Vest Thurston LLC CurrentSince Feb 15, 2020 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 1, 1998 Accepting new patients
Summit Consulting for Post Acute Care LLC CurrentSince Oct 1, 2019 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients

Locations

605 Woodland Square Loop SE
Lacey, WA 98503
Phone (312) 380-9455

3030 Limited Ln NW
Olympia, WA 98502
Phone (360) 352-6000

700 Lilly Rd NE
Olympia, WA 98506
Phone (360) 923-7000

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

209 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 596-3300

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Organizations & group practices 5

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": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1558427732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34584",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241584",
            "telephone_number": "509-241-7349",
            "fax_number": "509-241-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 10TH AVE SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985011566",
            "telephone_number": "350-349-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCKWELL",
        "first_name": "MELONIE",
        "middle_name": "K.",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "RN00064971",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP30000813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9627761",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.