Individual provider Active NPI

Melissa Erin Carolan, A.P.N.

  • Nurse Practitioner
  • Cookeville, TN
National Provider Identifier
1942337589
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
15983 Issued in TN
Practice address
406 N Whitney Ave Ste 5
Cookeville, TN 38501-4243
Phone
(931) 783-4269
Fax
(931) 372-0401
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 15983 TN Primary

Addresses

Primary practice location

406 N Whitney Ave Ste 5
Cookeville, TN 38501-4243

Mailing address

4230 Harding Pike
Ste 530
Nashville, TN 37205-2094
Phone (615) 222-5500

Other identifiers 3

IdentifierTypeStateIssuer
1525896MedicaidTN
7100423390MedicaidKY
4310834OtherTNBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20111130000506 TN Practitioner - Nurse Practitioner 6709050701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Tennessee, HSC, College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Thomas Medical PartnersGroup PAC ID 1557269354, 588 clinicians

Practice addresses (Care Compare)

300 20TH Ave N
Nashville, TN 37203-2131
Phone (615) 284-1400

4220 Harding Pike
Nashville, TN 37205-2005
Phone (615) 222-6977

Hospital & facility affiliations

  • Ascension Saint Thomas Hospital Hospital, Nashville, TN, CCN 440082

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Thomas Medical Partners CurrentSince Mar 2, 2020 Accepting new patients

Locations

300 20th Ave N
Ste 403
Nashville, TN 37203
Phone (615) 284-4088

300 20th Ave N
Fl 9
Nashville, TN 37203

4230 Harding Pike
Ste 530
Nashville, TN 37205
Phone (615) 222-5500

Interoperability endpoints

  • Direct secure messaging: melissa.carolan.1@7654.direct.athenahealth.com

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.

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1942337589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4230 HARDING PIKE",
            "address_2": "STE 530",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372052094",
            "telephone_number": "615-222-5500",
            "fax_number": "615-222-5601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 N WHITNEY AVE STE 5",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014243",
            "telephone_number": "931-783-4269",
            "fax_number": "931-372-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAROLAN",
        "first_name": "MELISSA",
        "middle_name": "ERIN",
        "name_prefix": "Ms.",
        "credential": "A.P.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "15983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1525896",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100423390",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4310834",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.