Melissa Anne Ellingson, MSN, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

R187505 Issued in MD

Practice address

12455 E 100TH St N Ste 300
Owasso, OK 74055-4678

Phone

(918) 274-9700

Fax

(918) 274-1395

NPI assigned

Sep 30, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: melissa.ellingson@jkp.gwaydirect.com
• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.973232

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.

• Aky MD, LLC

  • Pediatrics Physician
  • Moore, OK
  • NPI 1063846699
  NPD (past)
• Sprouts Child Development Initiative, Inc.

  • Prevention Professional
  • Tulsa, OK
  • NPI 1689107070
  NPD (past)
• Kidz Docs, PLLC

  • Pediatric Adolescent Medicine Physician
  • Alexandria, VA
  • NPI 1962616813
  NPD (past)
• Trusted Doctors LLC

  • Pediatrics Physician
  • Fairfax, VA
  • NPI 1083793525
  NPD (past)

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

{
    "created_epoch": "1317340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1891079430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12455 E 100TH ST N STE 300",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554678",
            "telephone_number": "918-274-9700",
            "fax_number": "918-274-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12455 E 100TH ST N STE 300",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554678",
            "telephone_number": "918-274-9700",
            "fax_number": "918-274-1395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLINGSON",
        "first_name": "MELISSA",
        "middle_name": "ANNE",
        "credential": "MSN, PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-30",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024170262",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OK",
            "license": "121520",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R187505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Travis Colton Eden, RDN
• Chad J Edwards, O.D.
• Tera Marchelle Egleston, D.C.
• Elizabeth Anne Eipp, RDN, LD
• Elevate Med Wellness PLLC
• Tyler Gregory Ellington, DO
• Annie Elliott
• Karen Ellis-Prentice
• Destiny Lyn Ellis, LPC-S
• Sageq Elrod

• Pediatric Nurse Practitioner in Owasso, OK
• Providers in Owasso, OK by specialty
• Pediatric Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.