Grace Marie Mellen, R.N. / N.P.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN120100 Issued in AZ

Practice address

10585 N Tatum Blvd
Suite D130
Paradise Valley, AZ 85253-1073

Phone

(602) 997-7263

Fax

(602) 944-4553

NPI assigned

Apr 9, 2015

Last updated

Apr 9, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22543/brand/1/csg/1/fhir/r4

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

• United Physicians Group LLC

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1316336845
  Medicare reassignment NPD

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

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428537600000",
    "number": "1184010852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 E. MCDOWELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062611",
            "telephone_number": "602-258-4951",
            "fax_number": "602-340-1853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10585 N TATUM BLVD",
            "address_2": "SUITE D130",
            "city": "PARADISE VALLEY",
            "state": "AZ",
            "postal_code": "852531073",
            "telephone_number": "602-997-7263",
            "fax_number": "602-944-4553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLEN",
        "first_name": "GRACE",
        "middle_name": "MARIE",
        "credential": "R.N. / N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-09",
        "last_updated": "2015-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP7444",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN120100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marwan Ghazoul MD PC
• Morgan Leigh Massingale, NMD
• Ana Lucia McNabb, FNP-C
• Susan McNamara, LPC, LISAC
• Brenna Amber Melanson
• Mercy Centre for Family Health PC
• MHPV Holdings PLC (Doctor Housecalls of Paradise Valley)
• Aspen Mitchell, PT, DPT
• Meredith Ann Molina
• Andrew M Moriarty, PT

• Registered Nurse in Paradise Valley, AZ
• Providers in Paradise Valley, AZ by specialty
• Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.