Active NPI
John Travis Melling, MD
- Family Medicine Physician
- Roseburg, OR
National Provider Identifier
1013536382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- PG199463
- Practice address
- 150 NE Kenneth Ford Dr
Roseburg, OR 97470-1042 - Phone
- (541) 672-9596
- Fax
- (541) 646-3519
- NPI assigned
- Apr 15, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | PG199463 | OR | Primary |
Addresses
Primary practice location
150 NE Kenneth Ford Dr
Roseburg, OR 97470-1042
Mailing address
150 NE Kenneth Ford Dr
Roseburg, OR 97470-1042
Phone (541) 672-9596
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PG199463 | OR | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586908800000",
"number": "1013536382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 NE KENNETH FORD DR",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974701042",
"telephone_number": "541-672-9596",
"fax_number": "541-646-3519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 NE KENNETH FORD DR",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974701042",
"telephone_number": "541-672-9596",
"fax_number": "541-646-3519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELLING",
"first_name": "JOHN",
"middle_name": "TRAVIS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-15",
"last_updated": "2020-04-15",
"certification_date": "2020-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "PG199463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Roseburg, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.