Individual provider Active NPI

Carrie A Melloh, MD

  • Family Medicine Physician
  • Fishers, IN
National Provider Identifier
1124052246
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01060755A Issued in IN
Practice address
8890 E 116TH St
Suite 300
Fishers, IN 46038-2820
Phone
(317) 621-1500
Fax
(317) 621-1509
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01060755A IN Primary

Addresses

Primary practice location

8890 E 116TH St
Suite 300
Fishers, IN 46038-2820

Mailing address

6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2890

Other identifiers 3

IdentifierTypeStateIssuer
000000602397OtherINANTHEM
000000659135OtherINANTHEM
200521880MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmelloh5577@eCommunityDirect.com Community Physicians of Indiana Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20050714001083 IN Practitioner - Family Practice 0749216257 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

8890 E 116TH St
Suite 300
Fishers, IN 46038-2857
Phone (317) 621-1500

Hospital & facility affiliations

  • Community Health at Home LLC Home health agency, Indianapolis, IN, CCN 157046
  • Community Hospital North Hospital, Indianapolis, IN, CCN 150169
  • Community Hospital East Hospital, Indianapolis, IN, CCN 150074
  • Riverview Health Hospital, Noblesville, IN, CCN 150059

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01060755AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc Family Medicine CurrentSince Aug 1, 2010 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Aug 1, 2010 Accepting new patients
Major Hospital Past Accepting new patients
Southside Emergency Associates Past Accepting new patients
Fishers Family Physicians Family Medicine Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

8890 E 116th St
Ste 300
Fishers, IN 46038
Phone (317) 621-1500

13050 Parkside Dr
Ste 230
Fishers, IN 46038
Phone (317) 588-5757

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

Interoperability endpoints

  • Direct secure messaging: cmelloh5577@ecommunitydirect.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1124052246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8890 E 116TH ST",
            "address_2": "SUITE 300",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460382820",
            "telephone_number": "317-621-1500",
            "fax_number": "317-621-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLOH",
        "first_name": "CARRIE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01060755A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000602397",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000659135",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200521880",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmelloh5577@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "8890 E 116th St",
            "address_2": "Suite 300",
            "city": "Fishers",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460382820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

Verify at the official NPI Registry.