Individual provider Active NPI

Melissa Lynne Wing, NP-C

  • Family Nurse Practitioner
  • Royal Oak, MI
National Provider Identifier
1912704800
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704314635 Issued in MI
Practice address
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone
(488) 984-0212
NPI assigned
Feb 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704314635 MI Primary

Addresses

Primary practice location

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

Mailing address

26901 Beaumont Blvd
Southfield, MI 48033-3849

Other names 1

  • Melissa Lynne Rust Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mrust1253852@epic00.shdirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20250521000315 MI Practitioner - Nurse Practitioner 6901324185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

28100 Grand River Ave
Farmington Hills, MI 48336-5970

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

3601 W 13 Mile Rd Ec
Beaumont Emergency Services Ro
Royal Oak, MI 48073-6712
Phone (248) 898-5058

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704314635MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Medical Group- Specialty Services CurrentSince Jun 15, 2025 Accepting new patients

Locations

28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320

3601 W 13 Mile Rd
Royal Oak, MI 48073

26901 Beaumont Blvd
Southfield, MI 48033
Phone (947) 522-1867

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

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": "1740614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1912704800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "488-984-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WING",
        "first_name": "MELISSA",
        "middle_name": "LYNNE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-27",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704314635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrust1253852@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "3601 W 13 Mile Rd",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "RUST",
            "middle_name": "LYNNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.