Individual provider Active NPI

Melissa May Bassett, FNP

  • Family Nurse Practitioner
  • Plymouth, MN
National Provider Identifier
1790962041
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP117247 Issued in TX
Practice address
4140 County Road 101 N
Plymouth, MN 55446-2308
Phone
(763) 478-4612
NPI assigned
Jan 29, 2008
Last updated
Aug 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 5234444-3102RN UT
Family Nurse Practitioner 363LF0000X 5234444-4405 UT
Family Nurse Practitioner 363LF0000X 5234444-4405APRN UT
Family Nurse Practitioner 363LF0000X AP117247 TX Primary
Family Nurse Practitioner 363LF0000X CNP2945 MN

Addresses

Primary practice location

4140 County Road 101 N
Plymouth, MN 55446-2308

Mailing address

7630 Fry Rd
Ste 300
Cypress, TX 77433-3376
Phone (281) 463-1400

Other names 1

  • Melissa May Hansen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 1, 2022 through Jul 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5234444-3102RNUTMDLicensed Vocational Nurse
CNP2945MNMDFamily Nurse Practitioner
AP117247TXMDFamily Nurse Practitioner
5234444-4405UTMDFamily Nurse Practitioner
5234444-4405APRNUTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nellie P. Grose, M.D., PA Past Accepting new patients
First Family Clinic, Inc. Past Accepting new patients
Clinic Service Providers, PA PastSince Jun 25, 2012 Accepting new patients
1St Medical of Annapolis, Inc. Past Accepting new patients

Organizations & group practices 4

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": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1790962041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7630 FRY RD",
            "address_2": "STE 300",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774333376",
            "telephone_number": "281-463-1400",
            "fax_number": "281-463-1432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 COUNTY ROAD 101 N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554462308",
            "telephone_number": "763-478-4612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSETT",
        "first_name": "MELISSA",
        "middle_name": "MAY",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-29",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "UT",
            "license": "5234444-3102RN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "5234444-4405",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "5234444-4405APRN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP117247",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP2945",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "HANSEN",
            "middle_name": "MAY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Plymouth, MN

Sources for this page

Verify at the official NPI Registry.