Individual provider Active NPI

Melissa Diane Herrmann, PT

  • Pediatric Physical Therapist
  • Hamburg, NY
National Provider Identifier
1497036107
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
008971-1 Issued in NY
Practice address
151 Sherburn Dr
Hamburg, NY 14075-3833
Phone
(716) 646-4494
NPI assigned
Sep 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 008971-1 NY
Pediatric Physical Therapist 2251P0200X 008971-1 NY Primary

Addresses

Primary practice location

151 Sherburn Dr
Hamburg, NY 14075-3833

Mailing address

151 Sherburn Dr
Hamburg, NY 14075-3833
Phone (716) 646-4494

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
008971-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1315440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1497036107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SHERBURN DR",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140753833",
            "telephone_number": "716-646-4494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 SHERBURN DR",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140753833",
            "telephone_number": "716-646-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRMANN",
        "first_name": "MELISSA",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-08",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "008971-1",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NY",
            "license": "008971-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamburg, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; 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.