Individual provider Active NPI

Melissa D Burgess, NP

  • Nurse Practitioner
  • Cookeville, TN
National Provider Identifier
1770753402
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
13278 Issued in TN
Practice address
1 Medical Center Blvd
Cookeville, TN 38501-4294
Phone
(931) 783-2334
Fax
(931) 783-2253
NPI assigned
Mar 10, 2008
Last updated
Feb 8, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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 13278 TN Primary

Addresses

Primary practice location

1 Medical Center Blvd
Cookeville, TN 38501-4294

Mailing address

PO Box 938
Cookeville, TN 38503-0938
Phone (931) 783-2334

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
I20080917000836 TN Practitioner - Nurse Practitioner 1355418229 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Putnam Emergency Physicians PLLCGroup PAC ID 3779946488, 34 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Blvd
Cookeville, TN 38501-4294
Phone (931) 528-2541

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13278TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
App of Tennessee Ed, PLLC Nurse Practitioner CurrentSince Feb 14, 2018 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Dec 14, 2015 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Dec 14, 2015 Accepting new patients
Putnam Emergency Physicians, PLLC CurrentSince Aug 1, 2023 Accepting new patients
Medical Observation Services LLC Past Accepting new patients

Locations

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1770753402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 938",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385030938",
            "telephone_number": "931-783-2334",
            "fax_number": "931-783-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014294",
            "telephone_number": "931-783-2334",
            "fax_number": "931-783-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "MELISSA",
        "middle_name": "D",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-10",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "13278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.