Active NPI
Larry Dale Melton, MD
- Emergency Medicine Physician
- Crestwood, KY
National Provider Identifier
1154976405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 25254
- Practice address
- 7712 Cambridge CT
Crestwood, KY 40014-8932 - Phone
- (502) 599-6341
- NPI assigned
- Aug 5, 2019
- Last updated
- Aug 5, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 25254 | KY | Primary |
Addresses
Primary practice location
7712 Cambridge CT
Crestwood, KY 40014-8932
Mailing address
7712 Cambridge CT.
Crestwood, KY 40014
Phone (502) 599-6341
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25254 | KY | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564963200000",
"number": "1154976405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7712 CAMBRIDGE CT.",
"city": "CRESTWOOD",
"state": "KY",
"postal_code": "40014",
"telephone_number": "502-599-6341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7712 CAMBRIDGE CT",
"city": "CRESTWOOD",
"state": "KY",
"postal_code": "400148932",
"telephone_number": "502-599-6341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELTON",
"first_name": "LARRY",
"middle_name": "DALE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-08-05",
"last_updated": "2019-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "KY",
"license": "25254",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crestwood, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.