NPIMap

Individual provider Active NPI

Melinda Louann Wiese, APRN, DNP

  • Nurse Practitioner
  • Owatonna, MN
National Provider Identifier
1801313796
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5376 Issued in MN
Practice address
2200 NW 26TH St
Owatonna, MN 55060-5503
Phone
(507) 451-1120
NPI assigned
Aug 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5376 MN
Nurse Practitioner 363L00000X 5376 MN Primary

Addresses

Primary practice location

2200 NW 26TH St
Owatonna, MN 55060-5503

Mailing address

2200 NW 26TH St
Owatonna, MN 55060-5503
Phone (507) 451-1120

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmallory108548@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171009001824 MN Practitioner - Nurse Practitioner 8224303755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Minnesota, Duluth School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mayo Clinic Health System-Southeast Minnesota RegionGroup PAC ID 4385556703, 550 clinicians

Practice addresses (Care Compare)

2250 NW 26TH St
Owatonna, MN 55060-5503
Phone (507) 451-3850

Hospital & facility affiliations

  • Hiawatha Homecare Home health agency, Red Wing, MN, CCN 247288
  • Interim Healthcare of Rochester Home health agency, Rochester, MN, CCN 248153
  • Adara Home Health Inc Home health agency, Buffalo, MN, CCN 248056
  • Mayo Clinic Health System in Red Wing Hospital, Red Wing, MN, CCN 240018
  • Mayo Clinic Health System - Lake City Hospital, Lake City, MN, CCN 241338
  • Mayo Clinic Health System - Cannon Falls Hospital, Cannon Falls, MN, CCN 241346
  • Mayo Clinic Hospital Rochester Hospital, Rochester, MN, CCN 240010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5376MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Oct 1, 2017 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Oct 1, 2017 Accepting new patients

Locations

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

2200 NW 26th St
Owatonna, MN 55060
Phone (507) 451-1120

2250 NW 26th St
Owatonna, MN 55060
Phone (507) 451-3850

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1801313796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 NW 26TH ST",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550605503",
            "telephone_number": "507-451-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 NW 26TH ST",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550605503",
            "telephone_number": "507-451-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESE",
        "first_name": "MELINDA",
        "middle_name": "LOUANN",
        "credential": "APRN, DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "5376",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "5376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmallory108548@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "2200 NW 26th St",
            "city": "Owatonna",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550605503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Owatonna, MN

Sources for this page

Verify at the official NPI Registry.