Individual provider Active NPI

John Mellott, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Flint, MI
National Provider Identifier
1952721730
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704304498NSA240ZT Issued in MI
Practice address
1040 W Bristol Rd
Flint, MI 48507-5516
Phone
(810) 257-3645
NPI assigned
Apr 21, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 4704304498 MI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704304498NSA240ZT MI Primary

Addresses

Primary practice location

1040 W Bristol Rd
Flint, MI 48507-5516

Mailing address

1040 W Bristol Rd
Flint, MI 48507-5516
Phone (810) 257-3645

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
I20250708001196 MI Practitioner - Nurse Practitioner 0547774028 Reassigns benefits to 3 organizations

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
Hurley Medical CenterGroup PAC ID 2961308481, shared by 10 NPIs, 336 clinicians
Genesee Health SystemGroup PAC ID 6002051091, 36 clinicians

Practice addresses (Care Compare)

1 Hurley PLZ
Flint, MI 48503-5902
Phone (810) 262-7333

1040 W Bristol Rd
Flint, MI 48507-5516
Phone (810) 257-3705

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704304498NSA240ZTMIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Genesee Health System Nurse Practitioner CurrentSince Apr 19, 2025 Accepting new patients
Hurley Medical Center CurrentSince Oct 1, 2025 Accepting new patients
Hurley Medical Center CurrentSince Oct 1, 2025 Accepting new patients
Hurley Medical Center Nurse Practitioner CurrentSince Oct 1, 2025 Accepting new patients
Genesee Health System CurrentSince Apr 19, 2025 Accepting new patients
Hurley Medical Center Current Accepting new patients

Locations

422 W 4th Ave
Flint, MI 48503
Phone (810) 496-5500

1085 S Linden Rd
Ste 150
Flint, MI 48532
Phone (810) 262-2100

420 W 5th Ave
Flint, MI 48503
Phone (810) 257-3724

1040 W Bristol Rd
Flint, MI 48507
Phone (810) 257-3724

1 Hurley Plz
Flint, MI 48503
Phone (810) 257-9000

Organizations & group practices 6

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": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1952721730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 W BRISTOL RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485075516",
            "telephone_number": "810-257-3645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 W BRISTOL RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485075516",
            "telephone_number": "810-257-3645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLOTT",
        "first_name": "JOHN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-21",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704304498",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704304498NSA240ZT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.