Melissa Anne Smith, MSN, APN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ01009500 Issued in NJ

Practice address

1200 S Church St Ste 18
Mount Laurel, NJ 08054-2936

Phone

(856) 639-6500

Fax

(856) 329-7827

NPI assigned

Nov 15, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Ms. Melissa Anne Boisselle Former name

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1649571175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S CHURCH ST STE 18",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542936",
            "telephone_number": "856-639-6500",
            "fax_number": "856-329-7827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S CHURCH ST STE 18",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542936",
            "telephone_number": "856-639-6500",
            "fax_number": "856-329-7827"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "219 Meadow Dr",
            "address_purpose": "LOCATION",
            "city": "Johnstown",
            "state": "PA",
            "postal_code": "159055314",
            "country_code": "US",
            "telephone_number": "856-639-6500",
            "fax_number": "856-329-7827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MELISSA",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "MSN, APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-15",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continuing Education/Staff Development",
            "state": "NJ",
            "license": "26NR12116300",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NR12116300",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01009500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI2",
            "identifier": "1821702564",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0905976",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "BOISSELLE",
            "middle_name": "ANNE",
            "prefix": "MS.",
            "credential": "MSN, APN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Smile America PC
• Smiles Associates, LLC (Growing Smiles of Mount Laurel)
• Brooke Smith, BCBA
• Dawn Smith, BCBA
• Maisha Smith, MSW, LCSW, DOULA
• Pamela Smith
• Shevon Borde Smith
• Tiffany Nicole Smith, MA CCC-SLP
• David Smoger, MD
• Brianna Snyder, BCBA

• Psychiatric/Mental Health Nurse Practitioner in Mount Laurel, NJ
• Providers in Mount Laurel, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.