Active NPI
Melissa Renee Avitia
- Physical Therapy Assistant
- Troy, MO
National Provider Identifier
1386866002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 14-02054
- Practice address
- 951 W College St
Troy, MO 63379-1112 - Phone
- (636) 462-6098
- NPI assigned
- May 3, 2007
- Last updated
- Oct 14, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2009036117 | MO | |
| Physical Therapy Assistant | 225200000X | 14-02054 | KS | Primary |
Addresses
Primary practice location
951 W College St
Troy, MO 63379-1112
Mailing address
951 W College St
Troy, MO 63379-1112
Phone (636) 462-6098
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 |
|---|---|---|---|
| 14-02054 | KS | MD | Physical Therapy Assistant |
| 2009036117 | MO | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lincoln County Reorganzied | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760400000000",
"number": "1386866002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "951 W COLLEGE ST",
"city": "TROY",
"state": "MO",
"postal_code": "633791112",
"telephone_number": "636-462-6098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "951 W COLLEGE ST",
"city": "TROY",
"state": "MO",
"postal_code": "633791112",
"telephone_number": "636-462-6098"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVITIA",
"first_name": "MELISSA",
"middle_name": "RENEE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-03",
"last_updated": "2025-10-14",
"certification_date": "2025-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MO",
"license": "2009036117",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "KS",
"license": "14-02054",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Troy, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.