Melvin Medlock, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4226 Issued in SC

Practice address

130 Dillon Drive
Spartanburg, SC 29307

Phone

(864) 585-2027

NPI assigned

May 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Mary Black Health System LLC

  • Physical Medicine & Rehabilitation Physician
  • Spartanburg, SC
  • NPI 1083640981
  NPD (past)
• Mary Black Physicians Group LLC

  • Family Medicine Physician
  • Spartanburg, SC
  • NPI 1295823045
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225411200000",
    "number": "1356397558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277827",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303847827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 DILLON DRIVE",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "29307",
            "telephone_number": "864-585-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLOCK",
        "first_name": "MELVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2008-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "4226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042260",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PTAN#",
            "identifier": "P00386799",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Medexpress Primary Care South Carolina, P.C.
• Medical & Surgical Dermatology, LLC
• Medical Services of America Inc
• Roxie C Medley, LPC
• Anthony Ty Medlin, PA-C
• Medq Medical Supply
• Annie M Meeks, COTA
• Sydney Nicole Meese, PA
• Daniel Boyd Meetze, MD
• Megan Black Counseling, LLC

• Family Medicine Physician in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2008; 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.