Active NPI
Melinda Brock, RD
- Registered Dietitian
- Woodward, OK
National Provider Identifier
1376747055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD939
- Practice address
- 900 17TH St.
Woodward, OK 73801 - Phone
- (580) 254-8456
- Fax
- (580) 254-8457
- NPI assigned
- Jun 14, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD939 | OK | Primary |
Addresses
Primary practice location
900 17TH St.
Woodward, OK 73801
Mailing address
900 17TH St.
Woodward, OK 73801
Phone (580) 254-8456
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 |
|---|---|---|---|
| LD939 | OK | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376747055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 17TH ST.",
"city": "WOODWARD",
"state": "OK",
"postal_code": "73801",
"telephone_number": "580-254-8456",
"fax_number": "580-254-8457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 17TH ST.",
"city": "WOODWARD",
"state": "OK",
"postal_code": "73801",
"telephone_number": "580-254-8456",
"fax_number": "580-254-8457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROCK",
"first_name": "MELINDA",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OK",
"license": "LD939",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodward, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.