Active NPI
Mellissa Leone Bayles, PT, MPT
- Pediatric Physical Therapist
- Phoenix, AZ
National Provider Identifier
1093928871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 2557
- Practice address
- 455 North 3Rd St Suite 200
Phoenix, AZ 85004 - Phone
- (602) 258-3450
- Fax
- (602) 258-3439
- NPI assigned
- May 8, 2007
- Last updated
- Jul 8, 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 2557 | AZ | Primary |
Addresses
Primary practice location
455 North 3Rd St Suite 200
Phoenix, AZ 85004
Mailing address
6156 W Wagoner Road
Glendale, AZ 85308
Phone (602) 843-3657
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2557 | AZ | MD | Pastoral Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093928871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6156 W WAGONER ROAD",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "85308",
"telephone_number": "602-843-3657",
"fax_number": "602-843-3699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 NORTH 3RD ST SUITE 200",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85004",
"telephone_number": "602-258-3450",
"fax_number": "602-258-3439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAYLES",
"first_name": "MELLISSA",
"middle_name": "LEONE",
"name_prefix": "Mrs.",
"credential": "PT, MPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "AZ",
"license": "2557",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
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.