Melanie Yvette Willis, FNP-C

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP226239 Issued in LA

Practice address

401 W 70TH St
Shreveport, LA 71106-3034

Phone

(318) 868-4552

NPI assigned

Jun 21, 2022

Last updated

Oct 25, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• David Raines Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Shreveport, LA
  • NPI 1215933254
  Medicare reassignment NPD
• Minden Physician Practices LLC

  • Multi-Specialty Clinic/Center
  • Minden, LA
  • NPI 1497986764
  Medicare reassignment NPD
• David Raines Community Health Center, Inc

  dba David Raines Community Health Center- Mobile Medical Unit #3

  • Federally Qualified Health Center (FQHC)
  • Shreveport, LA
  • NPI 1205721487
  NPD
• David Raines Community Health Center, Inc

  dba David Raines Community Health Center- Mobile Medical Unit #1

  • Federally Qualified Health Center (FQHC)
  • Shreveport, LA
  • NPI 1275317455
  NPD
• Minden Physician Practices LLC

  dba Minden Medical Clinic of Haughton

  • Rural Health Clinic/Center
  • Haughton, LA
  • NPI 1699392589
  NPD
• Minden Physician Practices LLC

  dba Workfit Industrial Medicine

  • Family Nurse Practitioner
  • Minden, LA
  • NPI 1265777957
  NPD (past)

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

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1902537947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W 70TH ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711063034",
            "telephone_number": "318-868-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W 70TH ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711063034",
            "telephone_number": "318-868-4552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "431 Homer Rd",
            "address_purpose": "LOCATION",
            "city": "Minden",
            "state": "LA",
            "postal_code": "710552993",
            "country_code": "US",
            "telephone_number": "318-377-8855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "MELANIE",
        "middle_name": "YVETTE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-21",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "LA",
            "license": "AP226239",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "LA",
            "license": "AP226239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Amanda Willis
• Kavori Rishe Willis, BS- PSYCHOLOGY
• Kenya Washington Willis, RPH
• Lakisha Willis
• Lindsey Willis, LPC
• Michael B Willis, PA
• Nekeicha Willis
• Reginald Willis
• Shalena Willis
• Tyekia Willis

• Pediatric Nurse Practitioner in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Pediatric Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.