Active NPI
Melissa Gottschlich, PA-C
- Medical Physician Assistant
- Blue Ash, OH
National Provider Identifier
1417490293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 50.004917RX
- Practice address
- 4260 Glendale Milford Rd
Suite 201
Blue Ash, OH 45242-3763 - Phone
- (513) 619-9229
- NPI assigned
- Nov 28, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 50.004917RX | OH | Primary |
Addresses
Primary practice location
4260 Glendale Milford Rd
Suite 201
Blue Ash, OH 45242-3763
Mailing address
4260 Glendale Milford Rd
Suite 201
Blue Ash, OH 45242-3763
Phone (513) 619-9229
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 |
|---|---|---|---|
| 50.004917RX | OH | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480291200000",
"number": "1417490293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4260 GLENDALE MILFORD RD",
"address_2": "SUITE 201",
"city": "BLUE ASH",
"state": "OH",
"postal_code": "452423763",
"telephone_number": "513-619-9229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4260 GLENDALE MILFORD RD",
"address_2": "SUITE 201",
"city": "BLUE ASH",
"state": "OH",
"postal_code": "452423763",
"telephone_number": "513-619-9229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOTTSCHLICH",
"first_name": "MELISSA",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-11-28",
"last_updated": "2016-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "OH",
"license": "50.004917RX",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blue Ash, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.