Active NPI
Bespoke Body & Wellness
- Family Nurse Practitioner
- Meridian, ID
National Provider Identifier
1104680602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Alison Melle, NP
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 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 DirectoryPractitioners & 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.