MELANIE M NELSON (PHD) – Clinical Psychologist, NPI 1114935830

MELANIE M NELSON (PHD) is a healthcare provider. based in Glen st mary, Florida. specializing in Clinical Psychologist. They hold the professional credentials PHD. They hold a License No. 1027 (OK). The NPI Number for MELANIE M NELSON (PHD) is 1114935830

Main info

Female
24 Years Of Experience
Accepts Medicare Assignment
Name
MELANIE M NELSON (PHD)
NPI
1114935830
Phone
(904) 653-1818
Address
PO BOX 606
Enumeration Date
5 August 2006
Last Update Date
25 November 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3522658990
Graduation Year
2002 (24 years ago)
PAC ID
1951305382
Group Practice PAC ID
0345146254
Professional Enrollment ID
I20141028002223
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:19State licenses:2Digital endpointsOther names

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Provider Addresses for MELANIE M NELSON (PHD)

  • Glen St. Mary, Baker County, Florida, 32040, United States

    GLEN ST MARY, FL 320400606

    Phone: (904) 653-1818

    Fax: (904) 653-1814

    Type: Mailing

  • 871, Southwest State Road 47, Lake City, Columbia County, Florida, 32025, United States

    LAKE CITY, FL 320250433

    Phone: (386) 438-8615

    Fax: (386) 438-8614

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-10-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20141028002223IClinical PsychologistFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32040)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0345146254View full group profile

Reviews

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Frequently asked questions

Does MELANIE M NELSON (PHD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MELANIE M NELSON (PHD) uses 1114935830.
Is MELANIE M NELSON (PHD) listed as active for patients and plans?
The listing shows MELANIE M NELSON (PHD) as active in the NPI system.
What is MELANIE M NELSON (PHD)'s specialty?
The listing groups MELANIE M NELSON (PHD) with Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What area does MELANIE M NELSON (PHD) serve?
MELANIE M NELSON (PHD)'s listing highlights Glen St Mary, Florida; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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