Melissa Dyan Anderson, PT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

PT2826 Issued in AR

Practice address

500 Tiger Blvd
Bentonville, AR 72712-2011

Phone

(479) 254-5065

NPI assigned

Apr 24, 2007

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

Practice roles

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.

• Bentonville Public Schools

  • Local Education Agency (LEA)
  • Bentonville, AR
  • NPI 1902941255
  NPD (past)

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497974109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 WOODLAND DR",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727561717",
            "telephone_number": "479-936-7647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 TIGER BLVD",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727122011",
            "telephone_number": "479-254-5065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MELISSA",
        "middle_name": "DYAN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "AR",
            "license": "PT2826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amerita, Inc.
• Jennifer Dyan Ames
• Amethyst Chiropractic, PLLC
• Anchor Counseling
• Lauren Anderson, BCBA
• Chandler Benson Long Anglin, OTR/L
• Clint Lee Anglin, ATC,LAT
• Rachel Angulo, MNSC, APRN, CPNP-PC
• Travis Wayne Anschutz, M.D.
• Jillian Antonowicz

• Pediatric Physical Therapist in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Pediatric Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.