Individual provider Active NPI

Bryan Keith Melancon, NP

  • Family Nurse Practitioner
  • Baton Rouge, LA
National Provider Identifier
1922005206
Registry record updated Jun 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
87222-4549 Issued in LA
Practice address
8585 Picardy Ave
Baton Rouge, LA 70809
Phone
(225) 763-4764
Fax
(225) 763-4549
NPI assigned
Jul 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2018

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 87222-4549 LA Primary

Addresses

Primary practice location

8585 Picardy Ave
Baton Rouge, LA 70809

Mailing address

8585 Picardy Ave
Baton Rouge, LA 70809-3748
Phone (225) 763-4764

Other practice location 1

3600 Florida Blvd
Baton Rouge, LA 70806-3842
Phone (225) 387-7070

Other practice location 2

11333 Church St
Clinton, LA 70722-3124
Phone (225) 683-3901

Other identifiers 1

IdentifierTypeStateIssuer
1470872MedicaidLA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050120000038 LA Practitioner - Nurse Practitioner 3678522349 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7373 Perkins Rd
Baton Rouge, LA 70808-4326
Phone (225) 246-9790

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
87222-4549LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baton Rouge Clinic, a Medical Corporation CurrentSince Dec 31, 2018 Accepting new patients
Baton Rouge Clinic, a Medical Corporation CurrentSince Dec 31, 2018 Accepting new patients
The Hospital Service District of West Feliciana Parish Louisiana Current Accepting new patients
Zachary Internal Medicine Clinic LLC Past Accepting new patients
Baton Rouge Clinic, a Medical Corporation Past Accepting new patients
Hospital Medicine Group Inc Past Accepting new patients
La Westfork, LLC Past Accepting new patients
Baton Rouge General Physicians, Inc. Past Accepting new patients

Locations

7373 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 246-9790

8585 Picardy Ave
Baton Rouge, LA 70809
Phone (225) 763-4000

3600 Florida St
Baton Rouge, LA 70806
Phone (225) 381-2615

3401 North Blvd
Ste 130
Baton Rouge, LA 70806
Phone (225) 381-2789

4739 Highway 10
Jackson, LA 70748
Phone (225) 634-0094

5266 Commerce St
Bldg A
Saint Francisville, LA 70775
Phone (225) 635-2441

1169 Highway 19
#B
Slaughter, LA 70777
Phone (225) 513-7155

1181 Highway 19
Slaughter, LA 70777
Phone (225) 306-0030

5266 Commerce St
St Francisvle, LA 70775
Phone (225) 635-3811

5266 Commerce St
#A
St Francisvle, LA 70775

4601 McHugh Rd
#B
Zachary, LA 70791
Phone (225) 683-1600

Interoperability endpoints

  • Direct secure messaging: bryan.melancon.1@18086.direct.athenahealth.com

Organizations & group practices 8

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": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1922005206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8585 PICARDY AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093748",
            "telephone_number": "225-763-4764",
            "fax_number": "225-763-4549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8585 PICARDY AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70809",
            "telephone_number": "225-763-4764",
            "fax_number": "225-763-4549"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 Florida Blvd",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708063842",
            "country_code": "US",
            "telephone_number": "225-387-7070",
            "fax_number": "225-372-3717",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11333 Church St",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "LA",
            "postal_code": "707223124",
            "country_code": "US",
            "telephone_number": "225-683-3901",
            "fax_number": "225-683-4150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELANCON",
        "first_name": "BRYAN",
        "middle_name": "KEITH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "87222-4549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1470872",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.