Individual provider Active NPI

Warner Melendez, PTA

  • Physical Therapy Assistant
  • Greeley, CO
National Provider Identifier
1285025528
Registry record updated Feb 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA.0013517 Issued in CO
Practice address
4663 W 20TH Street Rd
Greeley, CO 80634-3246
Phone
(970) 352-8762
NPI assigned
Feb 9, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA.0013517 CO Primary

Addresses

Primary practice location

4663 W 20TH Street Rd
Greeley, CO 80634-3246

Mailing address

4663 W 20TH Street Rd
Greeley, CO 80634-3246
Phone (970) 352-8762

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

LicenseStateTypeSpecialty
PTA.0013517COMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423440000000",
    "number": "1285025528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4663 W 20TH STREET RD",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806343246",
            "telephone_number": "970-352-8762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4663 W 20TH STREET RD",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806343246",
            "telephone_number": "970-352-8762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELENDEZ",
        "first_name": "WARNER",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-09",
        "last_updated": "2015-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CO",
            "license": "PTA.0013517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; 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.