Mary Elizabeth Melvin, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME144060 Issued in FL

Practice address

3028 4TH St Ste a&B
Marianna, FL 32446-2127

Phone

(850) 718-2886

Fax

(850) 633-5908

NPI assigned

Mar 27, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: marymelvin@jh.allscriptsdirect.net

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.

• ER Physician Group at Jackson Hospital

  • General Practice Physician
  • Marianna, FL
  • NPI 1407801194
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1003347337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3028 4TH ST STE A&B",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324462127",
            "telephone_number": "850-718-2886",
            "fax_number": "850-633-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3028 4TH ST STE A&B",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324462127",
            "telephone_number": "850-718-2886",
            "fax_number": "850-633-5908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 Davis Blvd",
            "address_2": "Suite 308",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336063475",
            "country_code": "US",
            "telephone_number": "813-250-2506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELVIN",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME144060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Stone McKeithan, PHARMACIST
• Stephen Tracy Mears, ARNP
• Mefl, LLC
• Krishnakamal C Mehta, BDS
• Brittany Lynne Melville, APRN
• Mid-South Home Care Services, Inc.
• Deborah Milam, P.A.
• Megan C Milton, ARNP
• Alex Sarmen Mirakian
• Keionna D Mitchell, APRN

• Pediatrics Physician in Marianna, FL
• Providers in Marianna, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.