Organization Active NPI

South Hill Pain & Wellness

  • Pain Management Registered Nurse
  • Edmonds, WA
National Provider Identifier
1619737764
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Management Registered NurseTaxonomy code 163WP0000X
Legal business name
SOUTH HILL PAIN & WELLNESS
Practice address
21701 76TH Ave W Ste 104
Edmonds, WA 98026-7536
Phone
(425) 375-5689
NPI assigned
Mar 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Authorized official

Name
Melissa Ann Barclay, ARNPNPI 1053943993
Title
NP/Owner
Phone
(425) 476-1100

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
Pain Management Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WP0000X Primary

Addresses

Primary practice location

21701 76TH Ave W Ste 104
Edmonds, WA 98026-7536

Mailing address

21701 76TH Ave W Ste 104
Edmonds, WA 98026-7536
Phone (425) 476-1100

Other names 1

  • Active Health & Wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240604001269 WA Part B Supplier - Clinic/Group Practice 2769924919 Receives reassigned benefits from 1 practitioner
Practice locations: Edmonds, WA

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": "1710806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764633600000",
    "number": "1619737764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21701 76TH AVE W STE 104",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267536",
            "telephone_number": "425-476-1100",
            "fax_number": "425-748-7782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21701 76TH AVE W STE 104",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267536",
            "telephone_number": "425-375-5689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH HILL PAIN & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-19",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A",
        "authorized_official_last_name": "BARCLAY",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "NP/OWNER",
        "authorized_official_telephone_number": "425-476-1100",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "163WP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Pain Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Health & Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Active Health & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.