Individual provider Active NPI

Melissa Lynn Harrison, CRNP

  • Nurse Practitioner
  • Northport, AL
National Provider Identifier
1811971468
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1078663 Issued in AL
Practice address
4280 Watermelon Rd Ste 112
Northport, AL 35473-5250
Phone
(205) 750-0030
Fax
(205) 750-0855
NPI assigned
Dec 6, 2005
Last updated
Feb 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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 1078663 AL Primary

Addresses

Primary practice location

4280 Watermelon Rd Ste 112
Northport, AL 35473-5250

Mailing address

4280 Watermelon Rd Ste 112
Northport, AL 35473-5250
Phone (205) 750-0030

Other identifiers 2

IdentifierTypeStateIssuer
051523138OtherALBCBS
051523138MedicaidAL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address melissa.harrison.p1@direct.crd.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20041117001003 AL Practitioner - Nurse Practitioner 5890759930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WV Medical Services PCGroup PAC ID 0840254975, 7 clinicians

Practice addresses (Care Compare)

4280 Watermelon Rd
Suite 112
Northport, AL 35473-5250
Phone (205) 750-0030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1078663ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medicine of Tuscaloosa, LLC Past Accepting new patients
Urgent Care Northwest PC PastSince May 12, 2026 Accepting new patients
Tuscaloosa Medcenter South, LLC PastSince Apr 1, 2008 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15818/brand/1/csg/1/fhir/r4

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": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1811971468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4280 WATERMELON RD STE 112",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354735250",
            "telephone_number": "205-750-0030",
            "fax_number": "205-750-0855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4280 WATERMELON RD STE 112",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354735250",
            "telephone_number": "205-750-0030",
            "fax_number": "205-750-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "MELISSA",
        "middle_name": "LYNN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1078663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051523138",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051523138",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "melissa.harrison.p1@direct.crd.nextgenshare.com",
            "affiliation": "N",
            "address_1": "4280 Watermelon Rd Ste 112",
            "city": "Northport",
            "state": "AL",
            "country_code": "US",
            "postal_code": "354735250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Northport, AL

Sources for this page

Verify at the official NPI Registry.