Individual provider Active NPI

Melissa K McRae, D.O.

  • Family Medicine Physician
  • Mount Gilead, OH
National Provider Identifier
1073508982
Registry record updated Feb 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34007177B Issued in OH
Practice address
900 Meadow Dr
Suite C
Mount Gilead, OH 43338-1063
Phone
(419) 946-1085
Fax
(419) 946-1209
NPI assigned
Sep 16, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34007177B OH Primary

Addresses

Primary practice location

900 Meadow Dr
Suite C
Mount Gilead, OH 43338-1063

Mailing address

7326 State Route 19
Unit 5014
Mount Gilead, OH 43338-9354
Phone (419) 946-1527

Other identifiers 1

IdentifierTypeStateIssuer
2274444MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190221001634 OH Order and Referring Only - Family PracticePractitioner - Family Practice 7214824846

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34007177BOHMDFamily Medicine Physician
7177OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bucyrus Community Hospital LLC Past Accepting new patients
Meridia Medical Group, LLC Past Accepting new patients
Clinic Regional Physicians LLC Family Medicine Past Accepting new patients
Incare Health Solutions LLC PastSince Jan 12, 2020 Accepting new patients
Radiology Associates of Canton, Inc. Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265155200000",
    "number": "1073508982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7326 STATE ROUTE 19",
            "address_2": "UNIT 5014",
            "city": "MOUNT GILEAD",
            "state": "OH",
            "postal_code": "433389354",
            "telephone_number": "419-946-1527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MEADOW DR",
            "address_2": "SUITE C",
            "city": "MOUNT GILEAD",
            "state": "OH",
            "postal_code": "433381063",
            "telephone_number": "419-946-1085",
            "fax_number": "419-946-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCRAE",
        "first_name": "MELISSA",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-16",
        "last_updated": "2010-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34007177B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2274444",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Gilead, OH

Sources for this page

Verify at the official NPI Registry.