Stacy Eldon Mellum, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

7499 Issued in NV

Practice address

635 Innovation Dr Ste 300
Reno, NV 89511-2215

Phone

(775) 329-6241

Fax

(775) 329-4921

NPI assigned

Nov 1, 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 1

Medicare fee-for-service enrollment

Enrolled in NV

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

Specialty

Obstetrics/Gynecology

Education

University of Nevada School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

OB-GYN Associates LTDGroup PAC ID 4486633500, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Renown Regional Medical Center Hospital, Reno, NV, CCN 290001

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• OB-GYN Associates LTD

  • Obstetrics & Gynecology Physician
  • Reno, NV
  • NPI 1992888283
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Renown Regional Medical Center

  • General Acute Care Hospital
  • Reno, NV
  • NPI 1124098421
  Care Compare affiliation
• Renown Regional Medical Center

  • General Acute Care Hospital
  • Sparks, NV
  • NPI 1932517299
  Care Compare affiliation

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1366520280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 INNOVATION DR STE 300",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112215",
            "telephone_number": "775-329-6241",
            "fax_number": "775-329-4921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 INNOVATION DR STE 300",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112215",
            "telephone_number": "775-329-6241",
            "fax_number": "775-329-4921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLUM",
        "first_name": "STACY",
        "middle_name": "ELDON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NV",
            "license": "7499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20-16628",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Melia
• Melinda M Kuhn DMD PC
• Marcus William Mellberg
• Erika Marie Mellor, M.A.
• Nathanael Duane Mellum, PMHNP
• Mayra Melo
• Amanda Lauren Melone, M.D.
• Andrew-Peter Drury Melone, M.D.
• Agnes T Melton, M.D.
• Janis Melton, RN

• Obstetrics & Gynecology Physician in Reno, NV
• Providers in Reno, NV by specialty
• Obstetrics & Gynecology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.