Active NPI
Melita Konecke, M.D.
- Family Medicine Physician
- Wilkes Barre, PA
National Provider Identifier
1093848459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD030045E
- Practice address
- 575 N River St
Wilkes Barre, PA 18764-0999 - Phone
- (570) 552-7260
- Fax
- (570) 552-7268
- NPI assigned
- Mar 14, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD030045E | PA | Primary |
Addresses
Primary practice location
575 N River St
Wilkes Barre, PA 18764-0999
Mailing address
575 N River St
Wilkes Barre, PA 18764-0999
Phone (570) 552-7260
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD030045E | PA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093848459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "575 N RIVER ST",
"city": "WILKES BARRE",
"state": "PA",
"postal_code": "187640999",
"telephone_number": "570-552-7260",
"fax_number": "570-552-7268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "575 N RIVER ST",
"city": "WILKES BARRE",
"state": "PA",
"postal_code": "187640999",
"telephone_number": "570-552-7260",
"fax_number": "570-552-7268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONECKE",
"first_name": "MELITA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "MD030045E",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilkes Barre, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.