Active NPI
Melissa Osborn
- Other Technician
- Grand Rapids, MI
National Provider Identifier
1194276139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- Practice address
- 4021 Keeweenaw Dr NE
Grand Rapids, MI 49525-2052 - Phone
- (503) 754-0866
- NPI assigned
- Oct 14, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Other Technician | 247200000X | MI | Primary |
Addresses
Primary practice location
4021 Keeweenaw Dr NE
Grand Rapids, MI 49525-2052
Mailing address
4021 Keeweenaw Dr NE
Grand Rapids, MI 49525-2052
Phone (503) 754-0866
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476403200000",
"number": "1194276139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4021 KEEWEENAW DR NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495252052",
"telephone_number": "503-754-0866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4021 KEEWEENAW DR NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495252052",
"telephone_number": "503-754-0866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSBORN",
"first_name": "MELISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-14",
"last_updated": "2016-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.