Individual provider Active NPI

Paul J Melrose, LMFT

  • Marriage & Family Therapist
  • Monona, WI
National Provider Identifier
1457572984
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1026-124 Issued in WI
Practice address
5900 Monona Dr
Suite 100
Monona, WI 53716-3554
Phone
(608) 663-0763
Fax
(608) 663-0765
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 4101006221 MI
Marriage & Family Therapist 106H00000X 1026-124 WI Primary

Addresses

Primary practice location

5900 Monona Dr
Suite 100
Monona, WI 53716-3554

Mailing address

5900 Monona Dr
Suite 100
Monona, WI 53716-3554
Phone (608) 663-0763

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

LicenseStateTypeSpecialty
4101006221MIMDMarriage & Family Therapist
1026-124WIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Counseling Center Past Accepting new patients
Samaritan Counseling Center of Southern Wisconsin Inc PastSince Apr 22, 2009 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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437609600000",
    "number": "1457572984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 MONONA DR",
            "address_2": "SUITE 100",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537163554",
            "telephone_number": "608-663-0763",
            "fax_number": "608-663-0765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 MONONA DR",
            "address_2": "SUITE 100",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537163554",
            "telephone_number": "608-663-0763",
            "fax_number": "608-663-0765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELROSE",
        "first_name": "PAUL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2015-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101006221",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "1026-124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monona, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.