Melinda A Douglas, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP011406 Issued in PA

Practice address

640 Alden St
Meadville, PA 16335-2348

Phone

(814) 373-5266

Fax

(814) 373-5269

NPI assigned

Jan 30, 2012

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Titusville Area HospitalGroup PAC ID 8022907575, shared by 16 NPIs, 77 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Titusville Area Hospital

  • Rural Health Clinic/Center
  • Titusville, PA
  • NPI 1316471212
  Medicare reassignment NPD
• Titusville Area Hospital

  dba Meadville Community Health Center

  • Rural Health Clinic/Center
  • Meadville, PA
  • NPI 1962964981
  Medicare reassignment NPD
• Titusville Area Hospital

  dba Conneaut Lake Health Center

  • Rural Health Clinic/Center
  • Conneaut Lake, PA
  • NPI 1053873976
  NPD
• Titusville Area Hospital

  • Audiologist
  • Titusville, PA
  • NPI 1306712104
  NPD
• Primary Care Services

  • Internal Medicine Physician
  • Meadville, PA
  • NPI 1962804955

  Family

  NPD (past)
• Titusville Area Hospital

  • Rural Health Clinic/Center
  • Oil City, PA
  • NPI 1760976336
  NPD (past)

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

{
    "created_epoch": "1327881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1679845192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 GROVE ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352945",
            "telephone_number": "814-373-5266",
            "fax_number": "814-373-5269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 ALDEN ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352348",
            "telephone_number": "814-373-5266",
            "fax_number": "814-373-5269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1034 Grove St",
            "address_purpose": "LOCATION",
            "city": "Meadville",
            "state": "PA",
            "postal_code": "163352945",
            "country_code": "US",
            "telephone_number": "814-333-5800",
            "fax_number": "814-333-5818",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "406 W Oak St",
            "address_purpose": "LOCATION",
            "city": "Titusville",
            "state": "PA",
            "postal_code": "163541499",
            "country_code": "US",
            "telephone_number": "814-827-9770",
            "fax_number": "814-827-3556",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "906 Washington St",
            "address_purpose": "LOCATION",
            "city": "Conneautville",
            "state": "PA",
            "postal_code": "164067138",
            "country_code": "US",
            "telephone_number": "814-587-2246",
            "fax_number": "814-587-4144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "MELINDA",
        "middle_name": "A",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-30",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP011406",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP011406",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA STATE BOARD OF NURSING",
            "identifier": "SP011406",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SafeHarbor@upmcdirect.com",
            "affiliation": "N",
            "endpointDescription": "secure UPMC direct address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1330 W 26th St",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "165081402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Nurse Practitioner in Meadville, PA
• Providers in Meadville, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.