Mellissa R Glenn, NP

Key facts

NPI

1568100725

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

114175 (NE)

Practice address

2700 W Norfolk Ave
Norfolk, NE 68701-4438

Phone

(402) 371-4880

NPI assigned

May 26, 2022

Sex

Female

Sole proprietor

No

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.

• Faith Regional Physician Services, LLC Family Medicine Physician · Norfolk, NE · NPI 1265489157
  Medicare reassignment Care Compare group NPD NE
• Faith Regional Physician Services, LLC Anesthesiology Physician · Norfolk, NE · NPI 1275074577
  NPD

Hospital & facility affiliations 6

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

• Avera St Anthonys Hospital Critical Access Hospital · O'Neill, NE · NPI 1891738936
  Care Compare affiliation Hospital
• Faith Regional Health Services General Acute Care Hospital · Norfolk, NE · NPI 1285676544
  Care Compare affiliation Hospital
• Providence Medical Center Critical Access Hospital · Wayne, NE · NPI 1801867494
  Care Compare affiliation Hospital
• Sacred Heart Health Services Family Medicine Physician · Creighton, NE · NPI 1083918171
  Care Compare affiliation Hospital
• Sacred Heart Health Services Critical Access Hospital · Creighton, NE · NPI 1225332471
  Care Compare affiliation Hospital
• West Holt Memorial Hospital Critical Access Hospital · Atkinson, NE · NPI 1295785442
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Faith Regional Physician Services LLC (194 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Faith Health Hospital · Norfolk, NE · CCN 280125
• Providence Medical Center Hospital · Wayne, NE · CCN 281345
• Avera St Anthony'S Hospital Hospital · O' Neill, NE · CCN 281329
• West Holt Memorial Hospital Hospital · Atkinson, NE · CCN 281343
• Avera Creighton Hospital Hospital · Creighton, NE · CCN 281331

Merit-based Incentive Payment System (MIPS)

Final score

95.27 of 100 (apm)

Quality

85.98

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

80.77 of 100 (group)

Quality

67.03

Promoting interoperability

96

Improvement activities

40

Cost

72.22

Medicare participation

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 26, 2022.

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1568100725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 W NORFOLK AVE",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687014438",
            "telephone_number": "402-371-4880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 W NORFOLK AVE",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687014438",
            "telephone_number": "402-371-4880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "MELLISSA",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "114175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Norfolk, NE · Family Nurse Practitioner in Nebraska