Jennifer Renea Mellis, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6747 Issued in NC

Practice address

6622 Gordon Rd Ste L
Wilmington, NC 28411-8415

Phone

(910) 407-7211

NPI assigned

Sep 20, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Coastline Therapy Group, LLC

  • Speech-Language Pathologist
  • Wilmington, NC
  • NPI 1730681388

  Physical Therapist

  Medicare reassignment NPD
• Power Up Therapy PC

  • Pediatric Occupational Therapist
  • Wilmington, NC
  • NPI 1487381489
  NPD
• Coastal Speech and Reading Center

  • Speech-Language Pathologist
  • Lumberton, NC
  • NPI 1649626466
  NPD (past)

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1386995108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6622 GORDON RD STE L",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284118415",
            "telephone_number": "910-407-7211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6622 GORDON RD STE L",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284118415",
            "telephone_number": "910-407-7211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Wrightsville Ave Ste 120",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284036256",
            "country_code": "US",
            "telephone_number": "910-679-8385",
            "fax_number": "910-679-8387",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8800 Sawmill Creek Ln",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284118353",
            "country_code": "US",
            "telephone_number": "910-228-6462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELLIS",
        "first_name": "JENNIFER",
        "middle_name": "RENEA",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-20",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "6747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Meisel
• Emily G Meister, PTA
• Daisy Jasmine Mejia, CFY-SLP
• Lisa Mejia, ARNP
• Thomas Eric Melin, M.D.
• Robert Paul Mellis, DDS
• Isaias E. Melo-Lizardo, MD
• Jonathan David Melo, DO
• Katherine Melton
• Miranda Rebecca Melton

• Physical Therapist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.