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MELLISSA WILLETTE BSN, IBCLC
NPI 1235607995
Nurse Practitioner in Fort Mill, SC

Active since November 10, 2018PECOS Enrolled
2209 SUNNY VALLEY CT, FORT MILL, SC 29707(864) 354-0786 Get Directions Write a Review

NPPES record last updated: July 24, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 24, 2023, Nov 10, 2018 (2 updates tracked since 2018).

About Mellissa Willette Bsn, Ibclc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MELLISSA WILLETTE BSN, IBCLC (NPI 1235607995) is an individual nurse practitioner in Fort Mill, South Carolina, licensed in South Carolina (27625) and active in the NPI registry since November 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1235607995
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMELLISSA WILLETTECredential: BSN, IBCLC
Location Address2209 SUNNY VALLEY CTFort Mill, SC 29707-7770
Mailing Address2209 Sunny Valley CtFort Mill, SC 29707-7770 · (864) 354-0786
Phone(864) 354-0786
Sole ProprietorYes
Enumeration DateNovember 10, 2018
Last NPPES UpdateJuly 24, 20232 updates tracked since enumeration
NPPES CertifiedJuly 21, 2023
✔ NPI 1235607995 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in SC · 27625
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedRegistered Nurse · Lactation ConsultantTaxonomy 163WL0100X · License L-35546 (SC)
2209 SUNNY VALLEY CT, Fort Mill, SC 29707
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mellissa Willette Bsn, Ibclc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Mellissa Willette reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Carolina Urgent & Family Care
16 mi
Primary Care
1130 HIGHWAY 9 BYP W
Lancaster, SC 29720
  • Reassigned Medicare billing, South Carolina enrollment
  • 3 clinicians in this Medicare group
NPI 1295761492 (803) 285-2225

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29707 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.18 typical visit price
range $53.57 – $163.84
Typical copayment $20.79 (range $13.39 – $40.96)
Most-billed visit code 99203
Established Patient
$95.12 typical visit price
range $16.96 – $133.52
Typical copayment $23.78 (range $4.24 – $33.38)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mellissa Willette's NPI number?

The NPI number for Mellissa Willette is 1235607995. It was assigned to this individual provider in the NPPES registry on November 10, 2018.

Where is Mellissa Willette located?

Mellissa Willette practices at 2209 Sunny Valley Ct, Fort Mill, SC 29707. The listed phone number is (864) 354-0786.

What is Mellissa Willette's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Mellissa Willette enrolled in Medicare?

Yes. Mellissa Willette is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mellissa Willette's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mellissa Willette reassigns Medicare benefits to Carolina Urgent & Family Care (Lancaster, SC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mellissa Willette's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mellissa Willette was last updated on July 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.