Active NPI
Melissa Marie Lennon, PT, DPT
- Pediatric Physical Therapist
- Grand Forks, ND
National Provider Identifier
1487032173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 1916
- Practice address
- 2200 Library Cir
Grand Forks, ND 58201-6326 - Phone
- (701) 757-2155
- NPI assigned
- May 13, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 1916 | ND | Primary |
Addresses
Primary practice location
2200 Library Cir
Grand Forks, ND 58201-6326
Mailing address
2200 Library Cir
Grand Forks, ND 58201-6326
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 |
|---|---|---|---|
| 1916 | ND | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435622400000",
"number": "1487032173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 LIBRARY CIR",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582016326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 LIBRARY CIR",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582016326",
"telephone_number": "701-757-2155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LENNON",
"first_name": "MELISSA",
"middle_name": "MARIE",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-13",
"last_updated": "2015-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "ND",
"license": "1916",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Forks, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.