Individual provider Active NPI

Melissa Devalon, MD

  • Family Medicine Physician
  • Monument, CO
National Provider Identifier
1457327025
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31126 Issued in CO
Practice address
15909 Jackson Creek Parkway
Monument, CO 80132
Phone
(719) 522-1133
Fax
(719) 481-1620
NPI assigned
Feb 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 31126 CO Primary

Addresses

Primary practice location

15909 Jackson Creek Parkway
Monument, CO 80132

Mailing address

2 South Cascade Avenue
Suite 140
Colorado Springs, CO 80903-1604
Phone (719) 538-2900

Other identifiers 1

IdentifierTypeStateIssuer
01311265MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200331001381 TX Practitioner - Family Practice 8325210974 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31126COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Warm Springs Health and Wellness DHHS IHS Warm Springs Service Unit CurrentSince Feb 3, 2020 Accepting new patients
Frederick Health Hospital Inc 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.

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465257600000",
    "number": "1457327025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SOUTH CASCADE AVENUE",
            "address_2": "SUITE 140",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809031604",
            "telephone_number": "719-538-2900",
            "fax_number": "719-538-2961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15909 JACKSON CREEK PARKWAY",
            "city": "MONUMENT",
            "state": "CO",
            "postal_code": "80132",
            "telephone_number": "719-522-1133",
            "fax_number": "719-481-1620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVALON",
        "first_name": "MELISSA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-24",
        "last_updated": "2016-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "31126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01311265",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monument, CO

Sources for this page

Verify at the official NPI Registry.