Individual provider Active NPI

Melanie Dawn Tudor

  • Registered Nurse
  • Little Rock, AR
National Provider Identifier
1104332964
Registry record updated Dec 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RO97018 Issued in AR
Practice address
6601 W 12TH St
Little Rock, AR 72204-1513
Phone
(501) 666-8686
NPI assigned
Dec 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RO97018 AR Primary

Addresses

Primary practice location

6601 W 12TH St
Little Rock, AR 72204-1513

Mailing address

6601 W 12TH St
Little Rock, AR 72204-1513
Phone (501) 666-8686

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

LicenseStateTypeSpecialty
RO97018ARMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1513296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513296000000",
    "number": "1104332964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 W 12TH ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041513",
            "telephone_number": "501-666-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 W 12TH ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041513",
            "telephone_number": "501-666-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUDOR",
        "first_name": "MELANIE",
        "middle_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-15",
        "last_updated": "2017-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "RO97018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2017; 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.