Individual provider Active NPI

Melody Wanda Minott, LPN

  • Licensed Practical Nurse
  • Tacoma, WA
National Provider Identifier
1366863896
Registry record updated Dec 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LP00046678 Issued in WA
Practice address
16317 25TH Avenue CT E
Tacoma, WA 98445-4510
Phone
(253) 298-2796
NPI assigned
Dec 31, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LP00046678 WA Primary

Addresses

Primary practice location

16317 25TH Avenue CT E
Tacoma, WA 98445-4510

Mailing address

16317 25TH Avenue CT E
Tacoma, WA 98445-4510
Phone (253) 298-2796

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LP00046678WAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1388448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388448000000",
    "number": "1366863896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16317 25TH AVENUE CT E",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984454510",
            "telephone_number": "253-298-2796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16317 25TH AVENUE CT E",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984454510",
            "telephone_number": "253-298-2796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOTT",
        "first_name": "MELODY",
        "middle_name": "WANDA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-31",
        "last_updated": "2013-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP00046678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2013; 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.