Individual provider Active NPI

Blake P Melling, MD

  • Family Medicine Physician
  • Morristown, TN
National Provider Identifier
1487605366
Registry record updated Dec 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD37751 Issued in TN
Practice address
4138 Durham LNDG
Morristown, TN 37813-1006
Phone
(423) 586-1717
Fax
(423) 586-1763
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2020

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 MD37751 TN Primary

Addresses

Primary practice location

4138 Durham LNDG
Morristown, TN 37813-1006

Mailing address

4138 Durham LNDG
Morristown, TN 37813-1006
Phone (423) 586-1717

Other identifiers 1

IdentifierTypeStateIssuer
3888940MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20050215000531 TN Practitioner - Family Practice 5193777480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Champion Physical Therapy LLC HallsGroup PAC ID 1355416306, shared by 4 NPIs, 277 clinicians
Healthstar Physicians PCGroup PAC ID 5890690978, 89 clinicians

Practice addresses (Care Compare)

3106 Circle Dr
White Pine, TN 37890-3306
Phone (865) 674-7454

3614 W Andrew Johnson Hwy
Morristown, TN 37814-3602
Phone (423) 586-9495

4138 Durham LNDG
Morristown, TN 37813-1006
Phone (423) 586-1717

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD37751TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthstar Physicians PC CurrentSince Nov 1, 2003 Accepting new patients
Healthstar Physicians, P.C. Family Medicine CurrentSince Nov 1, 2003 Accepting new patients
East Tennessee Primary Care Associates Family Medicine Past Accepting new patients

Locations

657 E Broadway Blvd
Ste C
Jefferson Cty, TN 37760
Phone (423) 586-1717

420 W Morris Blvd
Ste 400A
Morristown, TN 37813
Phone (423) 318-6617

4138 Durham Lndg
Morristown, TN 37813
Phone (423) 586-1717

5741 W Andrew Johnson Hwy
Morristown, TN 37814
Phone (423) 585-0686

420 W Morris Blvd
Ste 400C
Morristown, TN 37813
Phone (423) 586-0443

Interoperability endpoints

  • Direct secure messaging: blake.melling.1@3525.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1487605366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4138 DURHAM LNDG",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378131006",
            "telephone_number": "423-586-1717",
            "fax_number": "423-586-1763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4138 DURHAM LNDG",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378131006",
            "telephone_number": "423-586-1717",
            "fax_number": "423-586-1763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLING",
        "first_name": "BLAKE",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD37751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3888940",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, TN

Sources for this page

Verify at the official NPI Registry.