Individual provider Active NPI

Melissa Stacey Romero, CNP

  • Nurse Practitioner
  • Van Buren, AR
National Provider Identifier
1720596554
Registry record updated Jan 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A005301 Issued in AR
Practice address
1404 N 28TH St
Van Buren, AR 72956-2931
Phone
(479) 474-8021
NPI assigned
Jan 15, 2018
Last updated
Jan 15, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2018

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 A005301 AR Primary

Addresses

Primary practice location

1404 N 28TH St
Van Buren, AR 72956-2931

Mailing address

3723 W Locust St
Rogers, AR 72756-1868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20220725000869 WA Order and Referring Only - Nurse Practitioner 4587924667

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icp Arkansas Aco Billing LLC CurrentSince May 7, 2021 Accepting new patients
Icarepro of Texas, PA Past Accepting new patients

Locations

8050 Counts Massie Rd
Ste B
Maumelle, AR 72113
Phone (501) 492-0099

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": "1515974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515974400000",
    "number": "1720596554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3723 W LOCUST ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727561868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 N 28TH ST",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729562931",
            "telephone_number": "479-474-8021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "MELISSA",
        "middle_name": "STACEY",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-15",
        "last_updated": "2018-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A005301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Buren, AR

Sources for this page

Verify at the official NPI Registry.