Individual provider Active NPI

Claire Mellema, DPT

  • Physical Therapist
  • Mansfield, OH
National Provider Identifier
1225810070
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT020769 Issued in OH
Practice address
630 Lexington Ave
Mansfield, OH 44907-1500
Phone
(419) 515-3837
NPI assigned
Oct 17, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT020769 OH Primary

Addresses

Primary practice location

630 Lexington Ave
Mansfield, OH 44907-1500

Mailing address

291 1/2 Lee Ave
Ashland, OH 44805-2730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240923001820 OH Practitioner - Physical Therapist in Private Practice 4082155635 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of North Dakota School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bloomington Medical Services LLCGroup PAC ID 9032297627, 106 clinicians
Wooster Orthopaedics and Sportsmedicine IncGroup PAC ID 6204733355, 12 clinicians

Practice addresses (Care Compare)

1761 Beall Ave
Wooster, OH 44691-2342

3373 Commerce Pkwy
Suite 2
Wooster, OH 44691-7130
Phone (330) 804-9712

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT020769OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wooster Orthopaedics & Sportsmedicine Inc CurrentSince Jun 10, 2024 Accepting new patients
Bloomington Medical Services LLC CurrentSince Feb 1, 2026 Accepting new patients

Locations

3373 Commerce Pkwy
Ste 2
Wooster, OH 44691
Phone (330) 264-7643

1761 Beall Ave
Wooster, OH 44691
Phone (330) 263-8100

Interoperability endpoints

  • Direct secure messaging: cmellema@wosmc.medentdirect.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1697500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1225810070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 1/2 LEE AVE",
            "city": "ASHLAND",
            "state": "OH",
            "postal_code": "448052730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 LEXINGTON AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071500",
            "telephone_number": "419-515-3837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLEMA",
        "first_name": "CLAIRE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-17",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT020769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.