Individual provider Active NPI

Melinda Marie Bellomy-Muth, RN, NP

  • Women's Health Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1205820537
Registry record updated Aug 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
19904 Issued in CA
Practice address
1050 Linden Ave
Long Beach, CA 90813
Phone
(562) 491-4844
NPI assigned
Sep 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X R 163611-4 MN
Women's Health Nurse Practitioner 363LW0102X 19904 CA Primary

Addresses

Primary practice location

1050 Linden Ave
Long Beach, CA 90813

Mailing address

5509 Sunfield Ave
Lakewood, CA 90712-1855
Phone (801) 547-7417

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)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
R 163611-4MNMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533254400000",
    "number": "1205820537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5509 SUNFIELD AVE",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121855",
            "telephone_number": "801-547-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 LINDEN AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90813",
            "telephone_number": "562-491-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLOMY-MUTH",
        "first_name": "MELINDA",
        "middle_name": "MARIE",
        "credential": "RN, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-01",
        "last_updated": "2018-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MN",
            "license": "R 163611-4",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "19904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.