Individual provider Active NPI

Melissi Lynn Stanley, APN

  • Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1578098265
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
25667 Issued in TN
Practice address
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone
(309) 655-2000
NPI assigned
May 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Clinical Nurse Specialist 364SG0600X 209015906 IL
Nurse Practitioner 363L00000X 25667 TN Primary

Addresses

Primary practice location

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Mailing address

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 655-2000

Other names 1

  • Melissi Lynn Cravens Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20220124001828 TN Practitioner - Nurse Practitioner 1759620941 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Health System, Inc.Group PAC ID 5294646378, 512 clinicians

Practice addresses (Care Compare)

1940 Alcoa Hwy
Suite E260
Knoxville, TN 37920-2266
Phone (865) 305-6955

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.48 of 100Reported as apm
Quality
86.23
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25667TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Health System, Inc Current Accepting new patients
University Health System, Inc CurrentSince Jul 1, 2022 Accepting new patients
App of Tennessee HM, PLLC Nurse Practitioner CurrentSince Jan 17, 2022 Accepting new patients
University Health System Inc CurrentSince Jul 1, 2022 Accepting new patients
Knoxville Neurology Specialists, PLLC Past Accepting new patients

Locations

651 Dunlop Ln
Clarksville, TN 37040
Phone (931) 502-1000

2681 Andersonville Hwy
Ste 102
Clinton, TN 37716
Phone (865) 494-5960

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

1940 Alcoa Hwy
Ste E260
Knoxville, TN 37920
Phone (865) 305-6955

1940 Alcoa Hwy
Ste 260
Knoxville, TN 37920
Phone (610) 417-9229

9000 Executive Park Dr
Ste C200
Knoxville, TN 37923
Phone (865) 670-6142

1928 Alcoa Hwy
Ste B100
Knoxville, TN 37920
Phone (865) 305-6570

7565 Dannaher Dr
Powell, TN 37849
Phone (865) 545-8000

2835 Highway 231 N
Shelbyville, TN 37160
Phone (931) 685-5433

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1578098265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-655-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-655-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "MELISSI",
        "middle_name": "LYNN",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-01",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "IL",
            "license": "209015906",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "25667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSI",
            "last_name": "CRAVENS",
            "middle_name": "LYNN",
            "credential": "APN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.