Individual provider Active NPI

Melissa B Johnson, APNP

  • Nurse Practitioner
  • Green Bay, WI
National Provider Identifier
1558965640
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10589 Issued in WI
Practice address
2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone
(920) 288-8000
NPI assigned
Nov 30, 2020
Last updated
Nov 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 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 10589 WI Primary
Critical Care Neonatal Nurse Practitioner 363LN0005X 10589 WI

Addresses

Primary practice location

2845 Greenbrier Rd
Green Bay, WI 54311-6519

Mailing address

3301 W Forest Home Ave
Milwaukee, WI 53215-2843

Other practice location 1

1726 Shawano Ave
Green Bay, WI 54303-3282
Phone (920) 498-4200

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mjohnson69089@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20210125001535 WI Practitioner - Nurse Practitioner 0941614465 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10589WIMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Hospital-Hospital Sisters-Third Order of St. Francis CurrentSince Dec 1, 2020 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Dec 1, 2020 Accepting new patients
Baycare Aurora, LLC CurrentSince Jul 28, 2022 Accepting new patients
St Mary's Hospital Medical Center of Green Bay Inc.-Hospital Sisters CurrentSince Dec 1, 2020 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Nurse Practitioner Current Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Past Accepting new patients

Locations

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

2253 W Mason St
Green Bay, WI 54303
Phone (920) 327-7000

2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

3003 University Dr
Marinette, WI 54143
Phone (715) 732-8200

Interoperability endpoints

  • Direct secure messaging: mjohnson69089@direct.myadvocateaurora.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1558965640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 GREENBRIER RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116519",
            "telephone_number": "920-288-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1726 Shawano Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543033282",
            "country_code": "US",
            "telephone_number": "920-498-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MELISSA",
        "middle_name": "B",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-30",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "10589",
            "primary": true
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "WI",
            "license": "10589",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjohnson69089@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2845 Greenbrier Rd",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543116519",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2845 Greenbrier Rd",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543116519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.