Individual provider Active NPI

Melissa Irvine, AGACNP-BC

  • Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1851791024
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9297203 Issued in FL
Practice address
14320 Metropolis Ave Ste 1
Fort Myers, FL 33912-4539
Phone
(239) 277-5770
Fax
(239) 985-1911
NPI assigned
Aug 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X ARNP9297203 FL
Nurse Practitioner 363L00000X ARNP9297203 FL Primary

Addresses

Primary practice location

14320 Metropolis Ave Ste 1
Fort Myers, FL 33912-4539

Mailing address

2234 Colonial Blvd
Attn: Payer Contracting & Relations Dept.
Fort Myers, FL 33907-1412
Phone (239) 931-7342

Other identifiers 3

IdentifierTypeStateIssuer
5913871OtherFLAETNA
8028210OtherFLCIGNA
Y0PV3OtherFLBCBS

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 Apr 1, 2020 through Apr 1, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9297203FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Genesiscare USA of Florida LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1408924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1851791024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 COLONIAL BLVD",
            "address_2": "ATTN: PAYER CONTRACTING & RELATIONS DEPT.",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071412",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14320 METROPOLIS AVE STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124539",
            "telephone_number": "239-277-5770",
            "fax_number": "239-985-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRVINE",
        "first_name": "MELISSA",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-25",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "ARNP9297203",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9297203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5913871",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8028210",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y0PV3",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.