Active NPI
Melinda Rickard, LICENSE PHLEBOTOMIST
- Phlebotomy Technician
- Lebanon, OR
National Provider Identifier
1215785258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebotomy Technician
- License
- CPA-00003683
- Practice address
- 750 Walker Rd
Lebanon, OR 97355-1154 - Phone
- (760) 468-6491
- Fax
- (760) 433-8469
- NPI assigned
- May 6, 2024
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Blood Banking Specialist/Technologist | 246QB0000X | |||
| Medical Technologist | 246QM0706X | |||
| Microbiology Specialist/Technologist | 246QM0900X | |||
| Phlebotomy Technician | 246RP1900X | CPA-00003683 | CA | Primary |
Addresses
Primary practice location
750 Walker Rd
Lebanon, OR 97355-1154
Mailing address
750 Walker Rd
Lebanon, OR 97355-1154
Phone (760) 468-6491
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 588868439 | Other | CA | PASSPORT |
| C805650 | Other | OR | DRIVER'S LICENSE |
| 588868430 | Other | CA | PASSPORT |
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 |
|---|---|---|---|
| CPA-00003683 | CA | MD | Phlebotomy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714953600000",
"number": "1215785258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "750 WALKER RD",
"city": "LEBANON",
"state": "OR",
"postal_code": "973551154",
"telephone_number": "760-468-6491",
"fax_number": "760-433-8469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 WALKER RD",
"city": "LEBANON",
"state": "OR",
"postal_code": "973551154",
"telephone_number": "760-468-6491",
"fax_number": "760-433-8469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICKARD",
"first_name": "MELINDA",
"credential": "LICENSE PHLEBOTOMIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-06",
"last_updated": "2024-05-06",
"certification_date": "2024-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "246QB0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist/Technologist, Pathology, Blood Banking",
"state": null,
"license": null,
"primary": false
},
{
"code": "246QM0706X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Pathology, Medical Technologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "246QM0900X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Pathology, Microbiology",
"state": null,
"license": null,
"primary": false
},
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": "CA",
"license": "CPA-00003683",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PASSPORT",
"identifier": "588868439",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER'S LICENSE",
"identifier": "C805650",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PASSPORT",
"identifier": "588868430",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.