Active NPI
Alexis Mellem
- Neonatal Nurse Practitioner
- Round Rock, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Nurse Practitioner
- License
- AP121297
- Practice address
- 300 University Blvd
Round Rock, TX 78665-1032 - Phone
- (512) 509-0100
- NPI assigned
- Sep 11, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal Nurse Practitioner | 363LN0000X | 719875 | TX | |
| Neonatal Nurse Practitioner | 363LN0000X | AP121297 | TX | Primary |
Addresses
Primary practice location
300 University Blvd
Round Rock, TX 78665-1032
Mailing address
PO Box 844658
Dallas, TX 75284-4658
Phone (512) 963-2807
Other practice location 1
1201 W 38th St Fl 8
Austin, TX 78705-1006
Phone (512) 324-1085
Other practice location 2
3220 Feathergrass Ct
apt 9125
Austin, TX 78758-7777
Phone (512) 963-2807
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | amellem1258235@direct.sw.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 719875 | TX | MD | Neonatal Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scott and White Clinic | Current | Accepting new patients | |
| Scott & White Clinic | Current | Accepting new patients | |
| Scott & White Clinic | Current | Accepting new patients |
Locations
101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100
300 University Blvd
Round Rock, TX 78665
Phone (512) 509-0100
2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459
Interoperability endpoints
- amellem1258235@direct.sw.org
Organizations & group practices 3
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.
-
dba Baylor Scott & White Clinic - Temple
- Internal Medicine Physician
- Temple, TX
- NPI 1093779704
-
- Internal Medicine Physician
- Dallas, TX
- NPI 1649820796
-
- Radiation Oncology Physician
- Waxahachie, TX
- NPI 1821475153
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704326400000",
"number": "1346522877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 844658",
"city": "DALLAS",
"state": "TX",
"postal_code": "752844658",
"telephone_number": "512-963-2807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 UNIVERSITY BLVD",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786651032",
"telephone_number": "512-509-0100"
}
],
"practiceLocations": [
{
"address_1": "1201 W 38th St Fl 8",
"address_purpose": "LOCATION",
"city": "Austin",
"state": "TX",
"postal_code": "787051006",
"country_code": "US",
"telephone_number": "512-324-1085",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3220 Feathergrass Ct",
"address_2": "apt 9125",
"address_purpose": "LOCATION",
"city": "Austin",
"state": "TX",
"postal_code": "787587777",
"country_code": "US",
"telephone_number": "512-963-2807",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MELLEM",
"first_name": "ALEXIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-11",
"last_updated": "2024-01-04",
"certification_date": "2024-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "TX",
"license": "719875",
"primary": false
},
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "TX",
"license": "AP121297",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "amellem1258235@direct.sw.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "300 University Blvd",
"city": "Round Rock",
"state": "TX",
"country_code": "US",
"postal_code": "786651032",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Round Rock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.