Melissa Lynne Theall

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT40QA01485100 Issued in NJ

Practice address

240 Parker Ave
Manasquan, NJ 08736-2804

Phone

(732) 612-8412

NPI assigned

Sep 10, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1487323663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 PARKER AVE",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087362804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 PARKER AVE",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087362804",
            "telephone_number": "732-612-8412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEALL",
        "first_name": "MELISSA",
        "middle_name": "LYNNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "PT40QA01485100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Cognitive Coach LLC
• The Counseling Experience
• The Dermatology Clinic
• The Samaritan Center at the Jersey Shore
• The Talk Zone
• Adam Wesley Thomas, LPC, NCC
• Kristine Thompson, MS CCC-SLP
• Thrift Drug Inc
• Katrina Tinio, PA-C
• Toms River Ambulatory Anesthesia LLC

• Physical Therapist in Manasquan, NJ
• Providers in Manasquan, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.