Melanie Belleau Popp, CCC-A

Primary specialty

SpecialistTaxonomy code 174400000X

License

7640 Issued in MN

Practice address

5201 Eden Ave
Suite 50
Edina, MN 55436-2316

Phone

(952) 929-2060

Fax

(952) 929-2067

NPI assigned

Sep 19, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1295720902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 EDEN AVE",
            "address_2": "SUITE 50",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554362316",
            "telephone_number": "952-929-2060",
            "fax_number": "952-929-2067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 EDEN AVE",
            "address_2": "SUITE 50",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554362316",
            "telephone_number": "952-929-2060",
            "fax_number": "952-929-2067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPP",
        "first_name": "MELANIE",
        "middle_name": "BELLEAU",
        "credential": "CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-19",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MN",
            "license": "7640",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MN",
            "license": "2540",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500618000",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630175400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Polar Star Behavioral Health LLC
• Elaina Marie Polk, RN
• Virginia Pollen, DPT
• Nancy J Poole, CNP
• Joyce Popp, L.P.
• Pordford, Inc.
• Portable Diagnostic Imaging, Inc.
• Portable Diagnostic Imaging, Inc.
• Jean L Porter, MD
• Katherine Porter

• Specialist in Edina, MN
• Providers in Edina, MN by specialty
• Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.