Active NPI
Melodi Marie Gross, LPN
- Licensed Practical Nurse
- Madison, OH
National Provider Identifier
1124179684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN-107145
- Practice address
- 14814 Ford Rd
Madison, OH 44057-9528 - Phone
- (440) 628-4523
- NPI assigned
- Jan 12, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN-107145 | OH | Primary |
Addresses
Primary practice location
14814 Ford Rd
Madison, OH 44057-9528
Mailing address
PO Box 401
North Kingsville, OH 44068-0401
Phone (440) 224-2973
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
| License | State | Type | Specialty |
|---|---|---|---|
| PN-107145 | OH | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124179684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 401",
"city": "NORTH KINGSVILLE",
"state": "OH",
"postal_code": "440680401",
"telephone_number": "440-224-2973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14814 FORD RD",
"city": "MADISON",
"state": "OH",
"postal_code": "440579528",
"telephone_number": "440-628-4523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSS",
"first_name": "MELODI",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "PN-107145",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.