NPIMap

Individual provider Active NPI

Melissa Blann, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Lubbock, TX
National Provider Identifier
1396725446
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
K5257 Issued in TX
Practice address
3615 19TH St
Lubbock, TX 79410-1203
Phone
(806) 744-1887
Fax
(806) 744-5545
NPI assigned
Jan 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X K5257 TX Primary

Addresses

Primary practice location

3615 19TH St
Lubbock, TX 79410-1203

Mailing address

14275 Midway Rd
Suite 400
Addison, TX 75001-3614
Phone (806) 725-4271

Other identifiers 3

IdentifierTypeStateIssuer
220032896OtherTXMC RR
82914YOtherTXBCBS
153235001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120313000556 TX Practitioner - Pathology 3375697394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Texas Tech University Health Science Center School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3615 19TH St
Lubbock, TX 79410-1203
Phone (806) 744-1887

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
K5257TXMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ameripath Lubbock 5.01(a) Corporation Anatomic Pathology & Clinical Pathology CurrentSince Jul 15, 2002 Accepting new patients
Ameripath Lubbock 501a Corporation Anatomic Pathology & Clinical Pathology CurrentSince Jul 15, 2002 Accepting new patients
Ameripath Lubbock 501a Corporation Past Accepting new patients

Locations

14275 Midway Rd
Ste 400
Addison, TX 75001
Phone (214) 932-8018

1401 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-5630

3615 19th St
Lubbock, TX 79410
Phone (806) 725-0000

4000 24th St
Lubbock, TX 79410
Phone (806) 725-0000

2601 Dimmitt Rd
Plainview, TX 79072
Phone (806) 296-4282

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1396725446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14275 MIDWAY RD",
            "address_2": "SUITE 400",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013614",
            "telephone_number": "806-725-4271",
            "fax_number": "610-271-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 19TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101203",
            "telephone_number": "806-744-1887",
            "fax_number": "806-744-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANN",
        "first_name": "MELISSA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "K5257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC RR",
            "identifier": "220032896",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "82914Y",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153235001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.