Organization Active NPI

Nancy R. Mellin, MD

  • Otolaryngology Physician
  • Hammond, LA
National Provider Identifier
1518091008
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
020570 Issued in LA
Legal business name
NANCY R. MELLIN, MD
Practice address
15770 Paul Vega MD Dr
Suite #204
Hammond, LA 70403-1475
Phone
(985) 542-9155
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Authorized official

Name
Nancy R Mellin, MDNPI 1255330494
Title
Owner
Phone
(985) 542-9155

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 020570 LA Primary

Addresses

Primary practice location

15770 Paul Vega MD Dr
Suite #204
Hammond, LA 70403-1475

Mailing address

15770 Paul Vega MD Dr
Suite #204
Hammond, LA 70403-1475
Phone (985) 542-9155

Other identifiers 1

IdentifierTypeStateIssuer
1449407MedicaidLA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184544000000",
    "number": "1518091008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15770 PAUL VEGA MD DR",
            "address_2": "SUITE #204",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031475",
            "telephone_number": "985-542-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15770 PAUL VEGA MD DR",
            "address_2": "SUITE #204",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031475",
            "telephone_number": "985-542-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANCY R. MELLIN, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-16",
        "status": "A",
        "authorized_official_last_name": "MELLIN",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "985-542-9155",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "LA",
            "license": "020570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1449407",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.