Individual provider Active NPI

Nancy Melton, FNP

  • Nurse Practitioner
  • Choctaw, MS
National Provider Identifier
1659454650
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R533009 Issued in MS
Practice address
210 Hospital Cir
Choctaw, MS 39350-6781
Phone
(601) 656-2211
NPI assigned
Oct 23, 2006
Last updated
Oct 17, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R533009 MS Primary

Addresses

Primary practice location

210 Hospital Cir
Choctaw, MS 39350-6781

Mailing address

210 Hospital Cir
Choctaw, MS 39350-6781

Other identifiers 1

IdentifierTypeStateIssuer
00126049MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100617000119 TX Practitioner - Nurse Practitioner 6204966211 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mississippi Band of Choctaw Indians Current Accepting new patients

Locations

210 Hospital Cir
Choctaw, MS 39350
Phone (601) 389-4500

Organizations & group practices 1

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": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1659454650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 HOSPITAL CIR",
            "city": "CHOCTAW",
            "state": "MS",
            "postal_code": "393506781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 HOSPITAL CIR",
            "city": "CHOCTAW",
            "state": "MS",
            "postal_code": "393506781",
            "telephone_number": "601-656-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELTON",
        "first_name": "NANCY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R533009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00126049",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Choctaw, MS

Sources for this page

Verify at the official NPI Registry.