Individual provider Active NPI

Annamaria Melton, D.O.

  • Family Medicine Physician
  • Caldwell, ID
National Provider Identifier
1114612637
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4171372 Issued in ID
Practice address
712 Aviation Way
Caldwell, ID 83605-1154
Phone
(208) 302-7500
Fax
(208) 302-7555
NPI assigned
Apr 10, 2023
Last updated
Jul 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OL61432750 WA
Family Medicine Physician 207Q00000X 4171372 ID Primary
Family Medicine Physician 207Q00000X DOL.OL.61432750 WA

Addresses

Primary practice location

712 Aviation Way
Caldwell, ID 83605-1154

Mailing address

PO Box 190930
Boise, ID 83719-0930
Phone (208) 367-5170

Other practice location 1

1000 Wallace Way
Grandview, WA 98930-8805
Phone (509) 788-1702

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amelton41339@yvfwc.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231122003277 WA Order and Referring Only - Family PracticePractitioner - Family Practice 1052769437

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4171372IDMDFamily Medicine Physician
DOL.OL.61432750WAMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: amelton41339@yvfwc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1114612637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190930",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837190930",
            "telephone_number": "208-367-5170",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 AVIATION WAY",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836051154",
            "telephone_number": "208-302-7500",
            "fax_number": "208-302-7555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Wallace Way",
            "address_purpose": "LOCATION",
            "city": "Grandview",
            "state": "WA",
            "postal_code": "989308805",
            "country_code": "US",
            "telephone_number": "509-788-1702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELTON",
        "first_name": "ANNAMARIA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-10",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "OL61432750",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "4171372",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "DOL.OL.61432750",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amelton41339@yvfwc.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "YVFWC Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1000 Wallace Way",
            "city": "Grandview",
            "state": "WA",
            "country_code": "US",
            "postal_code": "989308805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

Verify at the official NPI Registry.