Individual provider Active NPI

Melissa Ann Stepchuk, NP-C

  • Adult Health Nurse Practitioner
  • Jackson, MI
National Provider Identifier
1922314350
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
A0211046 Issued in OH
Practice address
205 N East Ave
Jackson, MI 49201-1753
Phone
(517) 205-7289
Fax
(517) 205-1322
NPI assigned
Aug 23, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X A0211046 OH Primary

Addresses

Primary practice location

205 N East Ave
Jackson, MI 49201-1753

Mailing address

PO Box 67000 Department 272801
Provider Enrollment
Detroit, MI 48267-2728
Phone (517) 205-6248

Other practice location 1

2940 Ellsworth Rd
Ypsilanti, MI 48197-7406
Phone (734) 572-5777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A0211046OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Services of Florida LLC CurrentSince Sep 15, 2021 Accepting new patients
Olmsted Health & Services Corp. Past Accepting new patients

Locations

140 S Beach St
Ste 202
Daytona Beach, FL 32114
Phone (888) 506-8836

Organizations & group practices 2

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": "1282521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1922314350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67000 DEPARTMENT 272801",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482672728",
            "telephone_number": "517-205-6248",
            "fax_number": "517-205-7419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-205-7289",
            "fax_number": "517-205-1322"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2940 Ellsworth Rd",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "481977406",
            "country_code": "US",
            "telephone_number": "734-572-5777",
            "fax_number": "734-879-0326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPCHUK",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "A0211046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.