Individual provider Active NPI

Melissa Willette, NP-C

  • Community Health Nurse Practitioner
  • Plymouth, MA
National Provider Identifier
1922550557
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Nurse PractitionerTaxonomy code 363LC1500X
License
2272861 Issued in MA
Practice address
47 Obery St Ste 1a
Plymouth, MA 02360-2230
Phone
(508) 747-4883
NPI assigned
Oct 31, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2272861 MA
Family Nurse Practitioner 363LF0000X RN2272861 MA
Community Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LC1500X 2272861 MA Primary

Addresses

Primary practice location

47 Obery St Ste 1a
Plymouth, MA 02360-2230

Mailing address

20 Ash St
Middleboro, MA 02346-1002
Phone (774) 265-3638

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20170110003377 MA Practitioner - Nurse Practitioner 6406137207 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2272861MAMDCommunity Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pai Participant Ma PC Multi-Specialty CurrentSince Nov 27, 2023 Accepting new patients
Premier Healthcare Services, LLC Multi-Specialty Past Accepting new patients
Ipc Hospitalists of New England, P.C. Multi-Specialty Past Accepting new patients

Locations

111 Orient Ave
East Boston, MA 02128
Phone (617) 569-1200

Organizations & group practices 5

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": "1477872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1922550557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 ASH ST",
            "city": "MIDDLEBORO",
            "state": "MA",
            "postal_code": "023461002",
            "telephone_number": "774-265-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 OBERY ST STE 1A",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602230",
            "telephone_number": "508-747-4883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLETTE",
        "first_name": "MELISSA",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-31",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "2272861",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2272861",
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Community Health",
            "state": "MA",
            "license": "2272861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.