Individual provider Active NPI

Melanie Glass Watters, DPT

  • Physical Therapist
  • Flagstaff, AZ
National Provider Identifier
1255484580
Registry record updated Apr 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT10084 Issued in AZ
Practice address
2342 Mongwa Ovi
Flagstaff, AZ 86005-3531
Phone
(205) 531-5834
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 23143 FL
Physical Therapist 225100000X PTH6021 AL
Physical Therapist 225100000X PT10084 AZ Primary

Addresses

Primary practice location

2342 Mongwa Ovi
Flagstaff, AZ 86005-3531

Mailing address

2342 Mongwa Ovi
Flagstaff, AZ 86005-3531
Phone (205) 531-5834

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

State licenses

LicenseStateTypeSpecialty
PTH6021ALMDPhysical Therapist
PT10084AZMDPhysical Therapist
23143FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nature Coast Rehabilitation Inc Past Accepting new patients
New Day Wellness LLC PastSince Aug 5, 2020 Accepting new patients
Anniston Orthopedics Associates PA Past Accepting new patients
Anniston Orthopedics Associates PA Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1445

Organizations & group practices 4

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397001600000",
    "number": "1255484580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2342 MONGWA OVI",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860053531",
            "telephone_number": "205-531-5834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2342 MONGWA OVI",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860053531",
            "telephone_number": "205-531-5834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTERS",
        "first_name": "MELANIE",
        "middle_name": "GLASS",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2014-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "23143",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH6021",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "PT10084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2014; 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.