Individual provider Active NPI

Melissa Ann McNellis, RN

  • Registered Nurse
  • Savage, MN
National Provider Identifier
1760886642
Registry record updated Oct 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R136317-3 Issued in MN
Practice address
8640 Eagle Creek Circle
Savage, MN 55379
Phone
(952) 746-7664
Fax
(952) 746-0582
NPI assigned
Oct 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R136317-3 MN Primary

Addresses

Primary practice location

8640 Eagle Creek Circle
Savage, MN 55379

Mailing address

8640 Eagle Creek Circle
Savage, MN 55379
Phone (952) 746-7664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R136317-3MNMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413849600000",
    "number": "1760886642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8640 EAGLE CREEK CIRCLE",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "55379",
            "telephone_number": "952-746-7664",
            "fax_number": "952-746-0582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8640 EAGLE CREEK CIRCLE",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "55379",
            "telephone_number": "952-746-7664",
            "fax_number": "952-746-0582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNELLIS",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-21",
        "last_updated": "2014-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R136317-3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savage, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2014; 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.