DR. MELISSA WAYBRANT-ENNIS (APRN, DNP, PMHNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1780118885
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. MELISSA WAYBRANT-ENNIS (APRN, DNP, PMHNP-BC)
5230 6TH STREET FRONTAGE RD E
SPRINGFIELD, IL 627035128
Phone:
Type: Mailing
1859 SW NEWLAND WAY
LAKE CITY, FL 320256966
Phone: (386) 758-0003
Type: Mailing
5964 US HIGHWAY 90
LIVE OAK, FL 320608694
Phone: (302) 981-8484
Fax: (833) 672-3395
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $94.
Total Amount is formed as General ($94) + Research ($0) + Ownership ($0) = $94.
Last reported payment date: 2024-07-24 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($55).
Total Amount
$94
General + Research + Ownership
Payments
5
Total payment records
General Amount
$94
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $55 |
| Corium, LLC | $23 |
| Supernus Pharmaceuticals, Inc. | $17 |
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: 2019-11-21
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20191121000573 | I | Nurse Practitioner | FL | TBD |
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.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
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 62703)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MA | |
| - | FL | |
| - | FL | |
| - | FL | |
| - | FL |
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