Active NPI
Melville Medicine, PLLC
- Family Medicine Physician
- Southlake, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- MELVILLE MEDICINE, PLLC
- Practice address
- 1545 E Southlake Blvd Ste 110
Southlake, TX 76092-6464 - Phone
- (817) 600-8725
- NPI assigned
- Apr 18, 2019
- Last updated
- Dec 2, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Daniel Melville, MD
- Title
- Member
- Phone
- (817) 600-8725
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary | ||
| Adult Medicine Physician | 207QA0505X |
Addresses
Primary practice location
1545 E Southlake Blvd Ste 110
Southlake, TX 76092-6464
Mailing address
1545 E Southlake Blvd Ste 110
Southlake, TX 76092-6464
Phone (817) 676-2010
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2166939 | Melville Medicine, PLLC | Certificate of waiver | May 29, 2027 |
National Provider Directory
National Provider DirectoryInteroperability endpoints
- https://api.platform.athenahealth.com/22505/brand/1/csg/1/fhir/r4
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Southlake, TX
- NPI 1881646255
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555545600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1669939200000",
"number": "1043873771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1545 E SOUTHLAKE BLVD STE 110",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760926464",
"telephone_number": "817-676-2010",
"fax_number": "833-989-2353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1545 E SOUTHLAKE BLVD STE 110",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760926464",
"telephone_number": "817-600-8725"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MELVILLE MEDICINE, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-04-18",
"last_updated": "2022-12-02",
"certification_date": "2022-12-02",
"status": "A",
"authorized_official_last_name": "MELVILLE",
"authorized_official_first_name": "DANIEL",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "817-600-8725",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207QA0505X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Adult Medicine",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Southlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.