Melissa Wilcowski

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

751906 Issued in MN

Practice address

2524 Hannah Ave NW
Bemidji, MN 56601-2110

Phone

(218) 210-2100

NPI assigned

Aug 21, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Tru Healthcare, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gilbert, AZ
  • NPI 1386016822
  NPD (past)

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

{
    "created_epoch": "1724198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1699508168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2524 HANNAH AVE NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566012110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2524 HANNAH AVE NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566012110",
            "telephone_number": "218-210-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOWSKI",
        "first_name": "MELISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-21",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MN",
            "license": "751906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn Whiting, MA
• Chantel Justina Wickham, PT
• Charles-Camarin Widner, MSW, LGSW
• Deonne Margaret Widner, MSW, LICSW
• Jeffrey Scott Widner, LICSW
• David W Wilcox, MD
• Mark Wildgen, MD
• Geri C Wilimek, LICSW
• Jay F Wilimek, PH.D., L.P.
• Darlene Smith Wilkey, CNP

• All providers in Bemidji, MN
• Licensed Practical Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.