Individual provider Active NPI

Abby Melancon

  • Acute Care Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1902534035
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
905441 Issued in MS
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 984-1000
NPI assigned
Aug 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 905441 MS Primary

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

2029 Southwood Rd
Jackson, MS 39211-6032
Phone (601) 954-8118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20220927003815 MS Practitioner - Nurse Practitioner 7315323466 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2500 N State St
Jackson, MS 39216-4500
Phone (601) 815-4775

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
67.75
Promoting interoperability
100
Improvement activities
40
Cost
71.17

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Sep 16, 2022 Accepting new patients
App of Mississippi Ed, LLC CurrentSince Apr 3, 2023 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Sep 16, 2022 Accepting new patients
Jackson HB Medical Services LLC CurrentSince Aug 16, 2023 Accepting new patients

Locations

150 Reynoir St
Biloxi, MS 39530
Phone (228) 432-7817

504 Clinton Center Dr
Ste 4300
Clinton, MS 39056

1850 Chadwick Dr
Jackson, MS 39204
Phone (601) 376-1000

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

2100 Highway 61 N
Vicksburg, MS 39183
Phone (601) 883-5001

Interoperability endpoints

  • Direct secure messaging: athompson59130@ummc.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1902534035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2029 SOUTHWOOD RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392116032",
            "telephone_number": "601-954-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELANCON",
        "first_name": "ABBY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-08-08",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "905441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.