Melinda Annette Green

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Practice address

22 Meadowbrook Ave
Boardman, OH 44512-2605

Phone

(330) 774-4670

NPI assigned

Oct 15, 2020

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1063010676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 MEADOWBROOK AVE",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445122605",
            "telephone_number": "330-774-4670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 MEADOWBROOK AVE",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445122605",
            "telephone_number": "330-774-4670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MELINDA",
        "middle_name": "ANNETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-15",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5505995",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dillon Gorby, DPT
• Mioma D Gore
• Janet M. Gorsuch, CRNP
• Jeffrey Grace, CDCA
• John Michael Graff, MD
• Tiffany M Greene, PA-C
• Courtney Griffin
• Gloris Griffin, LPCC-SUPV, LICDC-S
• Margaret Griffin
• Sandra J Grisham, LPCC

• Developmental Disabilities Clinic/Center in Boardman, OH
• Providers in Boardman, OH by specialty
• Developmental Disabilities Clinic/Center in Ohio

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

Verify at the official NPI Registry.