Melodie Blakely, DPT, CWS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT14736 Issued in FL

Practice address

6200 Lee Vista Blvd Ste 250
Orlando, FL 32822-5104

Phone

(407) 240-3996

Fax

(866) 845-1899

NPI assigned

Feb 16, 2018

Last updated

Feb 16, 2018By the provider in NPPES

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 names 1

• Melodie Alcon Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• A2K Investments LLC

  dba Orlando Hyperbarics

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Orlando, FL
  • NPI 1396050647
  NPD (past)
• Walter a Conlan III MD PA

  dba Florida Wound Care Doctors

  • Physical Medicine & Rehabilitation Physician
  • Winter Park, FL
  • NPI 1558559765
  NPD (past)

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

{
    "created_epoch": "1518739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518739200000",
    "number": "1093215998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 LAKE HIGHLAND DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328032509",
            "telephone_number": "206-355-7957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 LEE VISTA BLVD STE 250",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328225104",
            "telephone_number": "407-240-3996",
            "fax_number": "866-845-1899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKELY",
        "first_name": "MELODIE",
        "name_prefix": "Dr.",
        "credential": "DPT, CWS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-16",
        "last_updated": "2018-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT14736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELODIE",
            "last_name": "ALCON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Banaly Blaise, LCSW
• Shannon Blake
• Sheila Blake, APRN
• Tanya Blake
• Elbert Q Blakely, BCBA-D
• Chanelle T Blakes
• Sophia Blakey-Cheung, MD
• Britt Blakey, MSW, LCSW
• Rana Blan, OTR/L
• Kimberly Blanc, MSW, LCSW

• Physical Therapist in Orlando, FL
• Providers in Orlando, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.