Active NPI
Melody Mukon, PA
- Medical Physician Assistant
- Norwich, CT
National Provider Identifier
1003047481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 000277
- Practice address
- 330 Washington St
Suite 220
Norwich, CT 06360-2700 - Phone
- (860) 886-8362
- Fax
- (860) 886-9262
- NPI assigned
- Aug 3, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 000277 | CT | Primary |
Addresses
Primary practice location
330 Washington St
Suite 220
Norwich, CT 06360-2700
Mailing address
330 Washington St
Suite 220
Norwich, CT 06360-2700
Phone (860) 886-8362
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000277 | CT | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1249257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249257600000",
"number": "1003047481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 WASHINGTON ST",
"address_2": "SUITE 220",
"city": "NORWICH",
"state": "CT",
"postal_code": "063602700",
"telephone_number": "860-886-8362",
"fax_number": "860-886-9262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 WASHINGTON ST",
"address_2": "SUITE 220",
"city": "NORWICH",
"state": "CT",
"postal_code": "063602700",
"telephone_number": "860-886-8362",
"fax_number": "860-886-9262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUKON",
"first_name": "MELODY",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-03",
"last_updated": "2009-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CT",
"license": "000277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norwich, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.