Melinda Beckman Mallette, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD42514 Issued in TN

Practice address

1370 Gateway Blvd.
Suite 110
Murfreesboro, TN 37129

Phone

(615) 890-9008

Fax

(615) 890-0193

NPI assigned

May 17, 2007

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

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.

• Grace Pediatrics PLLC

  • Pediatrics Physician
  • Smyrna, TN
  • NPI 1467781690
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402358400000",
    "number": "1356558605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 GATEWAY BLVD.",
            "address_2": "SUITE 110",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "37129",
            "telephone_number": "615-890-9008",
            "fax_number": "615-890-0193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 GATEWAY BLVD.",
            "address_2": "SUITE 110",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "37129",
            "telephone_number": "615-890-9008",
            "fax_number": "615-890-0193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLETTE",
        "first_name": "MELINDA",
        "middle_name": "BECKMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2014-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "MD42514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1503152",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Kaitlin Malick
• Muhammad Fayaz Malik, MD
• Eliza Echavez Mall, DNP
• Jack Daniel Mallette, DDS
• James Mallette, OTR/L
• Melissa Jane Malley, NP-C
• Katie Marie Mallinger, LCSW
• Madhavi Mallipeddi, MD
• Sarah Mallory, LCSW
• Ragan Malone

• Pediatrics Physician in Murfreesboro, TN
• Providers in Murfreesboro, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; 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.

Verify at the official NPI Registry.