Individual provider Active NPI

Melynda Michelle Jose, M.A.

  • Audiologist
  • Waterbury, CT
National Provider Identifier
1235220195
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
000279 Issued in CT
Practice address
1 Exchange PL
21 West Main Street, 3Rd Floor
Waterbury, CT 06702-2013
Phone
(203) 574-3777
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 000279 CT Primary
Audiologist-Hearing Aid Fitter 237600000X 000279 CT

Addresses

Primary practice location

1 Exchange PL
21 West Main Street, 3Rd Floor
Waterbury, CT 06702-2013

Mailing address

1 Exchange Place
21 West Main Street, 3Rd Floor
Waterbury, CT 06702-2013
Phone (203) 574-3777

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
279CTMDChiropractor
000279CTMDNaturopath

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1235220195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EXCHANGE PLACE",
            "address_2": "21 WEST MAIN STREET, 3RD FLOOR",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022013",
            "telephone_number": "203-574-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EXCHANGE PL",
            "address_2": "21 WEST MAIN STREET, 3RD FLOOR",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022013",
            "telephone_number": "203-574-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSE",
        "first_name": "MELYNDA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CT",
            "license": "000279",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "CT",
            "license": "000279",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; 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.