Individual provider Active NPI

Melissa Irene Chamberlain, APRN

  • Family Medicine Physician
  • Blountstown, FL
National Provider Identifier
1609907914
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2980662 Issued in FL
Practice address
16700 SE Pear St
Blountstown, FL 32424-2177
Phone
(850) 693-2543
NPI assigned
Mar 8, 2007
Last updated
Dec 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2980662 FL Primary

Addresses

Primary practice location

16700 SE Pear St
Blountstown, FL 32424-2177

Mailing address

16700 SE Pear St
Blountstown, FL 32424-2177
Phone (850) 693-2543

Other identifiers 1

IdentifierTypeStateIssuer
308230000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070411000342 FL Practitioner - Nurse Practitioner 2264537760 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2980662FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Memorial Healthcare Inc Family Medicine CurrentSince Jun 1, 2010 Accepting new patients
Tallahassee Memorial Healthcare Inc Family Medicine CurrentSince Jun 1, 2010 Accepting new patients
Tallahassee Memorial Healthcare Inc Current Accepting new patients
Tallahassee Memorial Healthcare Inc Current Accepting new patients
Sonder Wellness LLC Current Accepting new patients

Locations

16700 SE Pear St
Blountstown, FL 32424
Phone (850) 398-4425

17808 NE Charlie Johns St
Blountstown, FL 32424
Phone (850) 674-4524

1549 S Jefferson St
Monticello, FL 32344
Phone (850) 997-0707

1300 Miccosukee Rd
Tallahassee, FL 32308
Phone (850) 431-1155

1607 Saint James Ct
Ste 1
Tallahassee, FL 32308
Phone (850) 431-7021

Interoperability endpoints

  • Direct secure messaging: mchamberlain21427@tallahasseememorial.direct-ci.com
  • Direct secure messaging: melissachamberlain@tmhpp.allscriptsdirect.net

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, 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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1609907914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16700 SE PEAR ST",
            "city": "BLOUNTSTOWN",
            "state": "FL",
            "postal_code": "324242177",
            "telephone_number": "850-693-2543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16700 SE PEAR ST",
            "city": "BLOUNTSTOWN",
            "state": "FL",
            "postal_code": "324242177",
            "telephone_number": "850-693-2543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERLAIN",
        "first_name": "MELISSA",
        "middle_name": "IRENE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2023-12-11",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "2980662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "308230000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blountstown, FL

Sources for this page

Verify at the official NPI Registry.