Active NPI
Melissa Ann Hallum, APRN-CNP
- Family Nurse Practitioner
- Tishomingo, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R0092696
- Practice address
- 610 E 24TH St
Tishomingo, OK 73460-3245 - Phone
- (580) 371-2343
- Fax
- (580) 371-3614
- NPI assigned
- Nov 16, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1068494 | TX | |
| Family Nurse Practitioner | 363LF0000X | R0092696 | OK | Primary |
Addresses
Primary practice location
610 E 24TH St
Tishomingo, OK 73460-3245
Mailing address
610 E 24TH St
Tishomingo, OK 73460-3245
Phone (580) 371-2343
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200682930A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1020 N Commerce St
Mercy Clinic Primary Care Commerce
Ardmore, OK 73401-3920
Phone (580) 223-5311
Hospital & facility affiliations
- Ideal Home Care, L.P.
- Elara Caring Xxiii
- Mercy Hospital Ardmore, Inc
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0092696 | OK | MD | Family Nurse Practitioner |
| 1068494 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| QV Urgent Care TX PLLC | Current | Accepting new patients | |
| Mercy Clinic Oklahoma Communities | Current | Accepting new patients | |
| QV Urgent Care TX PLLC | Current | Accepting new patients | |
| Minuteclinic Diagnostic of Oklahoma LLC | Family | Current | Accepting new patients |
| Minuteclinic Telehealth Services of Texas Association | Family | Current | Accepting new patients |
| Summit Medical Center | Past | Accepting new patients | |
| Mercy Hospital Ardmore, Inc. | Past | Accepting new patients |
Locations
1020 N Commerce St
Ardmore, OK 73401
Phone (580) 223-5311
1040 SW 19th St
Moore, OK 73160
Phone (405) 794-3001
2100 SW 119th St
Oklahoma City, OK 73170
Phone (405) 691-1041
4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962
4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455
1600 US Highway 79 S
Henderson, TX 75654
Phone (903) 657-9571
1855 Gattis School Rd
Round Rock, TX 78664
Phone (512) 238-6268
Organizations & group practices 7
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.
-
- Family Medicine Physician
- Oklahoma City, OK
- NPI 1386874550
-
- Family Nurse Practitioner
- Edmond, OK
- NPI 1285765727
-
- Family Nurse Practitioner
- Round Rock, TX
- NPI 1922564301
-
- Family Medicine Physician
- Henderson, TX
- NPI 1568098887
-
- Rural Health Clinic/Center
- Madisonville, TX
- NPI 1669198347
-
- General Acute Care Hospital
- Ardmore, OK
- NPI 1386741635
-
- General Acute Care Hospital
- Edmond, OK
- NPI 1356574560
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Ardmore, OK
- NPI 1467430595
-
- Home Health Agency
- Ada, OK
- NPI 1932115722
-
- General Acute Care Hospital
- Ardmore, OK
- NPI 1386741635
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740528000000",
"number": "1760924153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 E 24TH ST",
"city": "TISHOMINGO",
"state": "OK",
"postal_code": "734603245",
"telephone_number": "580-371-2343",
"fax_number": "580-371-3614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 E 24TH ST",
"city": "TISHOMINGO",
"state": "OK",
"postal_code": "734603245",
"telephone_number": "580-371-2343",
"fax_number": "580-371-3614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLUM",
"first_name": "MELISSA",
"middle_name": "ANN",
"credential": "APRN-CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-16",
"last_updated": "2025-02-26",
"certification_date": "2025-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "1068494",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OK",
"license": "R0092696",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200682930A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tishomingo, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; 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.