Melissa Livingston, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11006400-4405 Issued in UT

Practice address

286 N Gateway Dr Ste 201
Providence, UT 84332-5603

Phone

(435) 932-6125

NPI assigned

Feb 25, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Synergy Youth Treatment

  • Mental Illness Community Based Residential Treatment Facility
  • Cornish, UT
  • NPI 1366873440
  NPD (past)

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

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1649804022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 628",
            "city": "MILLVILLE",
            "state": "UT",
            "postal_code": "843260628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 N GATEWAY DR STE 201",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843325603",
            "telephone_number": "435-932-6125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVINGSTON",
        "first_name": "MELISSA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-25",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "11006400-3102",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "11006400-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Providence",
            "affiliation": "N",
            "address_1": "286 N Gateway Dr Ste 201",
            "city": "Providence",
            "state": "UT",
            "country_code": "US",
            "postal_code": "843325603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Abigail Marie Leavitt, RBT
• Chloe Lewis, RBT
• Bobbie Liechty, M.A., CCC-SLP
• Little Squirts Therapy Services LLC
• Trajan Littlefield
• Grace Lords, PT,DPT
• Lori C. Novich-Welter, M.D., P.C.
• LP Derm LLC
• Robert William Pedro Lyday, DO
• Brian Thomas Lyman, D.C.

• Family Nurse Practitioner in Providence, UT
• Providers in Providence, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.