Individual provider Active NPI

Melissa Anne Winder, PHYSICAL THERAPIST

  • Physical Therapy Clinic/Center
  • Omaha, NE
National Provider Identifier
1053892083
Registry record updated Aug 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
3305 Issued in NE
Practice address
8031 W Center Rd
Omaha, NE 68124-3158
Phone
(402) 391-5002
NPI assigned
Aug 27, 2018
Last updated
Aug 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 3305 NE Primary

Addresses

Primary practice location

8031 W Center Rd
Omaha, NE 68124-3158

Mailing address

7107 S 161St St
Omaha, NE 68136-1086
Phone (913) 544-8159

Other names 1

  • Miss Melissa Anne Marion Former name

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

LicenseStateTypeSpecialty
3305NEMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1053892083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7107 S 161ST ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681361086",
            "telephone_number": "913-544-8159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8031 W CENTER RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681243158",
            "telephone_number": "402-391-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINDER",
        "first_name": "MELISSA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-27",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NE",
            "license": "3305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "MARION",
            "middle_name": "ANNE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; 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.