Individual provider Active NPI

Melissa Roberts, FNP

  • Family Nurse Practitioner
  • Maryville, TN
National Provider Identifier
1710388590
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19145 Issued in TN
Practice address
355 BMH Physicians Office BLDG
Maryville, TN 37804-5820
Phone
(865) 980-5060
Fax
(865) 980-5066
NPI assigned
Sep 11, 2014
Last updated
May 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 19145 TN Primary

Addresses

Primary practice location

355 BMH Physicians Office BLDG
Maryville, TN 37804-5820

Mailing address

103 West Broadway Avenue
Maryville, TN 37804
Phone (865) 273-1752

Other practice location 1

1706 E LaMar Alexander Pkwy
Maryville, TN 37804-6204
Phone (865) 983-0073

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20150430001850 TN Practitioner - Nurse Practitioner 3173842879 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optivrx, LLCGroup PAC ID 1254796675, 2 clinicians

Practice addresses (Care Compare)

2008 Chilhowee Medical Park
Maryville, TN 37804-5285
Phone (865) 500-4987

Merit-based Incentive Payment System (MIPS)

Final score
85.2 of 100Reported as group
Quality
70.4
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19145TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optivrx, LLC CurrentSince Jan 12, 2024 Accepting new patients
Edmunds Gastroenterology, PLLC CurrentSince Feb 1, 2023 Accepting new patients

Locations

1600 Breda Dr
Fl B
Knoxville, TN 37918
Phone (865) 500-4987

4713 Papermill Dr
Knoxville, TN 37909
Phone (865) 696-2906

4713 Papermill Dr
Ste 100
Knoxville, TN 37909
Phone (865) 851-7771

2008 Chilhowee Medical Park
Maryville, TN 37804
Phone (865) 500-4987

Organizations & group practices 2

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": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1710388590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 WEST BROADWAY AVENUE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "37804",
            "telephone_number": "865-273-1752",
            "fax_number": "865-273-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 BMH PHYSICIANS OFFICE BLDG",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045820",
            "telephone_number": "865-980-5060",
            "fax_number": "865-980-5066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1706 E LaMar Alexander Pkwy",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "TN",
            "postal_code": "378046204",
            "country_code": "US",
            "telephone_number": "865-983-0073",
            "fax_number": "865-983-2201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MELISSA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-11",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "19145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

Verify at the official NPI Registry.