Melanie Sample, RN

Primary specialty

Gerontology Registered NurseTaxonomy code 163WG0600X

License

28151524A Issued in IN

Practice address

9268 E Tate Ridge Rd
Madison, IN 47250-8756

Phone

(812) 493-3993

NPI assigned

Mar 2, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Melanie Smith Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1003563834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9268 E TATE RIDGE RD",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472508756",
            "telephone_number": "812-493-3993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9268 E TATE RIDGE RD",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472508756",
            "telephone_number": "812-493-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPLE",
        "first_name": "MELANIE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-02",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "IN",
            "license": "28151524A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELANIE",
            "last_name": "SMITH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Roy D Eaglin DMD
• Dan Rudin, MD
• Colleen Ryan, M.D.
• Lori Sachleben
• Debra Ann Sadler, MSW
• Christina Dawn Sauley-Kernen, P.T.A.
• Rebecca Schanding
• Ruth Schmidtchen
• Lawrence Hastings Schoch, M.D.
• Anthony J Schroeder, LCSW

• Gerontology Registered Nurse in Madison, IN
• Providers in Madison, IN by specialty
• Gerontology Registered Nurse in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.