Active NPI
Melba Lee
- Radiologic Technologist
- Fort Washakie, WY
National Provider Identifier
1598158719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiologic Technologist
- License
- CRT13831
- Practice address
- 29 Black Coal Road
Fort Washakie,, WY 82514 - Phone
- (307) 332-7672
- Fax
- (307) 335-7514
- NPI assigned
- Mar 12, 2015
- Last updated
- Mar 24, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiologic Technologist | 247100000X | CRT13831 | FL | Primary |
Addresses
Primary practice location
29 Black Coal Road
Fort Washakie,, WY 82514
Mailing address
29 Black Coal Drive
Fort Washakie,, WY 82514
Phone (307) 332-7672
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 215611 | Other | FL | ARRT |
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
| License | State | Type | Specialty |
|---|---|---|---|
| CRT13831 | FL | MD | Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427155200000",
"number": "1598158719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 BLACK COAL DRIVE",
"city": "FORT WASHAKIE,",
"state": "WY",
"postal_code": "82514",
"telephone_number": "307-332-7672",
"fax_number": "307-335-7514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 BLACK COAL ROAD",
"city": "FORT WASHAKIE,",
"state": "WY",
"postal_code": "82514",
"telephone_number": "307-332-7672",
"fax_number": "307-335-7514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "MELBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-12",
"last_updated": "2015-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "247100000X",
"taxonomy_group": "",
"desc": "Radiologic Technologist",
"state": "FL",
"license": "CRT13831",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARRT",
"identifier": "215611",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Washakie, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.