Active NPI
Melissa Elaine Wick, PT
- Acupuncturist
- Waupaca, WI
National Provider Identifier
1417119264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 777-55
- Practice address
- 105 N Western Ave
Waupaca, WI 54981-2201 - Phone
- (715) 802-5099
- Fax
- (715) 802-5100
- NPI assigned
- Jul 1, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 Therapist | 225100000X | 5146-024 | WI | |
| Acupuncturist | 171100000X | 777-55 | WI | Primary |
Addresses
Primary practice location
105 N Western Ave
Waupaca, WI 54981-2201
Mailing address
105 N Western Ave
Waupaca, WI 54981-2201
Phone (715) 802-5099
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 777-55 | WI | MD | Acupuncturist |
| 5146-024 | WI | MD | Physical Therapist |
| 5146 | WI | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Waupaca | Past | Accepting new patients | |
| North Eastern Wisconsin Rehabilitation Corporation | Physical Therapist | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Waupaca, WI
- NPI 1588631691
-
- Physical Therapist
- New London, WI
- NPI 1417017369
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1417119264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 N WESTERN AVE",
"city": "WAUPACA",
"state": "WI",
"postal_code": "549812201",
"telephone_number": "715-802-5099",
"fax_number": "715-802-5100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 N WESTERN AVE",
"city": "WAUPACA",
"state": "WI",
"postal_code": "549812201",
"telephone_number": "715-802-5099",
"fax_number": "715-802-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WICK",
"first_name": "MELISSA",
"middle_name": "ELAINE",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-01",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "5146-024",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "WI",
"license": "777-55",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waupaca, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.