Organization Active NPI

Bespoke Body & Wellness

  • Family Nurse Practitioner
  • Meridian, ID
National Provider Identifier
1104680602
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
BESPOKE BODY & WELLNESS
Practice address
4028 N Quenzer Way
Meridian, ID 83646-5928
Phone
(208) 398-9974
NPI assigned
Feb 6, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Authorized official

Name
Dr. Alison Melle, NPNPI 1770501397
Title
NP/Owner
Phone
(208) 398-9974

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

4028 N Quenzer Way
Meridian, ID 83646-5928

Mailing address

4028 N Quenzer Way
Meridian, ID 83646-5928
Phone (208) 398-9974

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1707177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707177600000",
    "number": "1104680602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4028 N QUENZER WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836465928",
            "telephone_number": "208-398-9974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4028 N QUENZER WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836465928",
            "telephone_number": "208-398-9974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BESPOKE BODY & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-06",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A",
        "authorized_official_last_name": "MELLE",
        "authorized_official_first_name": "ALISON",
        "authorized_official_title_or_position": "NP/OWNER",
        "authorized_official_telephone_number": "208-398-9974",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; 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.