Individual provider Active NPI

Melissa Coronado

  • Licensed Vocational Nurse
  • Amarillo, TX
National Provider Identifier
1366934192
Registry record updated Jun 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
31183 Issued in TX
Practice address
5125 Kirk Dr
Amarillo, TX 79110-3003
Phone
(806) 336-9034
NPI assigned
Jun 6, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 31183 TX Primary

Addresses

Primary practice location

5125 Kirk Dr
Amarillo, TX 79110-3003

Mailing address

5125 Kirk Dr
Amarillo, TX 79110-3003
Phone (806) 336-9034

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
31183TXMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1366934192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5125 KIRK DR",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791103003",
            "telephone_number": "806-336-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5125 KIRK DR",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791103003",
            "telephone_number": "806-336-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORONADO",
        "first_name": "MELISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-06",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "31183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; 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.