Active NPI
Juliann Mellen
- Registered Dietitian
- Syracuse, NY
National Provider Identifier
1003914037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 723266
- Practice address
- 90 Presidential PLZ
Syracuse, NY 13202-2240 - Phone
- (315) 464-3716
- NPI assigned
- Sep 21, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 723266 | NY | Primary |
Addresses
Primary practice location
90 Presidential PLZ
Syracuse, NY 13202-2240
Mailing address
90 Presidential PLZ
Syracuse, NY 13202-2240
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 723266 | NY | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genesee Valley Group Health Association | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinic Pharmacy
- Rochester, NY
- NPI 1962591875
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729728000000",
"number": "1003914037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 PRESIDENTIAL PLZ",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132022240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 PRESIDENTIAL PLZ",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132022240",
"telephone_number": "315-464-3716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELLEN",
"first_name": "JULIANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-21",
"last_updated": "2024-10-24",
"certification_date": "2024-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "723266",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.