Individual provider Active NPI

Melody Ruth Elam

  • Physical Therapy Assistant
  • Bella Vista, AR
National Provider Identifier
1497452072
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA4741 Issued in AR
Practice address
1801 Forest Hills Blvd Ste 205
Bella Vista, AR 72715-3071
Phone
(479) 855-9348
NPI assigned
Feb 14, 2023
Last updated
Feb 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA4741 AR Primary

Addresses

Primary practice location

1801 Forest Hills Blvd Ste 205
Bella Vista, AR 72715-3071

Mailing address

10028 Little Acres LN
Pea Ridge, AR 72751-9405
Phone (253) 320-6567

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
PTA4741ARMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mountaincrest Rehab of Bella Vista, Inc. CurrentSince Feb 19, 2023 Accepting new patients

Locations

1801 Forest Hills Blvd
Ste 205
Bella Vista, AR 72715
Phone (479) 855-9348

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1676332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1497452072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10028 LITTLE ACRES LN",
            "city": "PEA RIDGE",
            "state": "AR",
            "postal_code": "727519405",
            "telephone_number": "253-320-6567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 FOREST HILLS BLVD STE 205",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727153071",
            "telephone_number": "479-855-9348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELAM",
        "first_name": "MELODY",
        "middle_name": "RUTH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-14",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "PTA4741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bella Vista, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.