Individual provider Active NPI

Melissa A Boyles, PH.D.

  • Clinical Neuropsychologist
  • Louisville, KY
National Provider Identifier
1356333090
Registry record updated Jun 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
1351 Issued in KY
Practice address
2915 Frankfort Ave
Suite E
Louisville, KY 40206-2682
Phone
(502) 432-1611
Fax
(502) 893-4043
NPI assigned
Aug 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 1351 KY Primary

Addresses

Primary practice location

2915 Frankfort Ave
Suite E
Louisville, KY 40206-2682

Mailing address

2915 Frankfort Ave
Suite E
Louisville, KY 40206-2682
Phone (502) 432-1611

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1351KYMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Edelson and Associates, Inc. Clinical Neuropsychologist PastSince May 13, 2016 Accepting new patients
Optum Behavioral Care of North Carolina, P.C. Past Accepting new patients

Organizations & group practices 2

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244505600000",
    "number": "1356333090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 FRANKFORT AVE",
            "address_2": "SUITE E",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402062682",
            "telephone_number": "502-432-1611",
            "fax_number": "502-893-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 FRANKFORT AVE",
            "address_2": "SUITE E",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402062682",
            "telephone_number": "502-432-1611",
            "fax_number": "502-893-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLES",
        "first_name": "MELISSA",
        "middle_name": "A",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2009-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "KY",
            "license": "1351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2009; 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.