Active NPI
Melissa Jean Banther
- Marriage & Family Therapist
- Bloomfield, IN
National Provider Identifier
1225790694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 4573
- Practice address
- 10084 E State Road 54
Bloomfield, IN 47424-6063 - Phone
- (507) 703-3512
- NPI assigned
- Oct 12, 2021
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 4573 | MN | Primary |
Addresses
Primary practice location
10084 E State Road 54
Bloomfield, IN 47424-6063
Mailing address
10084 E State Road 54
Bloomfield, IN 47424-6063
Phone (507) 703-3512
Other names 1
- Melissa Jean Mart
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
504 N Walnut St
Seymour, IN 47274-1537
Phone (812) 671-8704
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Seymour, IN
- NPI 1568150068
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763337600000",
"number": "1225790694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10084 E STATE ROAD 54",
"city": "BLOOMFIELD",
"state": "IN",
"postal_code": "474246063",
"telephone_number": "507-703-3512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10084 E STATE ROAD 54",
"city": "BLOOMFIELD",
"state": "IN",
"postal_code": "474246063",
"telephone_number": "507-703-3512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANTHER",
"first_name": "MELISSA",
"middle_name": "JEAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-12",
"last_updated": "2025-11-17",
"certification_date": "2025-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "4573",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MELISSA",
"last_name": "MART",
"middle_name": "JEAN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bloomfield, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.