Active NPI
Melanie Blair-Dye, C.O.
- Orthotist
- Pomona, CA
National Provider Identifier
1376702142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotist
- License
- CO003166
- Practice address
- 320 E Bonita Ave
Pomona, CA 91767-1926 - Phone
- (909) 621-1180
- Fax
- (909) 624-1650
- NPI assigned
- Jun 5, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | CO003166 | CA | Primary |
Addresses
Primary practice location
320 E Bonita Ave
Pomona, CA 91767-1926
Mailing address
320 E Bonita Ave
Pomona, CA 91767-1926
Phone (909) 621-1180
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
| License | State | Type | Specialty |
|---|---|---|---|
| CO003166 | CA | MD | Orthotist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| J&K Orthopedics Inc | Orthotist | Past | Accepting new patients |
| J&K Orthopedics Inc | Orthotist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Orthotist
- Montclair, CA
- NPI 1184689085
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212624000000",
"number": "1376702142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 E BONITA AVE",
"city": "POMONA",
"state": "CA",
"postal_code": "917671926",
"telephone_number": "909-621-1180",
"fax_number": "909-624-1650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 E BONITA AVE",
"city": "POMONA",
"state": "CA",
"postal_code": "917671926",
"telephone_number": "909-621-1180",
"fax_number": "909-624-1650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAIR-DYE",
"first_name": "MELANIE",
"credential": "C.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-05",
"last_updated": "2008-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": "CA",
"license": "CO003166",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.