Individual provider Active NPI

Melissa Leah Coulter, CRNP/AGACNP-BC

  • Acute Care Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1841931128
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP025533 Issued in PA
Practice address
111 S 11TH St
Philadelphia, PA 19107-4824
Phone
(443) 472-3395
NPI assigned
Apr 2, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 26NJ15060900 NJ
Acute Care Nurse Practitioner 363LA2100X SP025533 PA Primary

Addresses

Primary practice location

111 S 11TH St
Philadelphia, PA 19107-4824

Mailing address

507 S 8TH St Apt 204
Philadelphia, PA 19147-1356
Phone (443) 472-3395

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221029000352 PA Practitioner - Nurse Practitioner 2062889389 Reassigns benefits to 1 organization
I20250729002963 NJ Practitioner - Nurse Practitioner 2062889389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
George Washington University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

1101 Chestnut St
Philadelphia, PA 19107-3619
Phone (800) 533-3669

111 S 11TH St
Philadelphia, PA 19107-4824

2201 Chapel Ave W
Cherry Hill, NJ 08002-2048
Phone (856) 513-4124

925 Chestnut St
Suite 3
Philadelphia, PA 19107-4216
Phone (215) 955-8874

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP025533PAMDAcute Care Nurse Practitioner
26NJ15060900NJMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Medical Group Practice, P.C. CurrentSince Jun 15, 2021 Accepting new patients
Jefferson University Physicians CurrentSince Jun 21, 2022 Accepting new patients
Kennedy Medical Group Practice PC CurrentSince Jul 1, 2025 Accepting new patients
Kennedy Medical Group Practice, P.C. CurrentSince Jul 1, 2025 Accepting new patients
Jefferson University Physicians Past Accepting new patients
Kennedy Medical Group Practice P.C. Past Accepting new patients

Locations

2201 Chapel Ave W
Cherry Hill, NJ 08002
Phone (856) 488-6500

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

18 E Laurel Rd
Stratford, NJ 08084
Phone (856) 346-6000

111 S 11th St
Philadelphia, PA 19107
Phone (215) 955-6161

1101 Market St
Fl 19
Philadelphia, PA 19107
Phone (215) 481-6836

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

834 Walnut St
Ste 650
Philadelphia, PA 19107
Phone (215) 928-7000

Organizations & group practices 6

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 2

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": "1648857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1841931128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 S 8TH ST APT 204",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191471356",
            "telephone_number": "443-472-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "443-472-3395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULTER",
        "first_name": "MELISSA",
        "middle_name": "LEAH",
        "credential": "CRNP/AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-02",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ15060900",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP025533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.