Individual provider Active NPI

Marley Mikell Melton, OTR/L

  • Occupational Therapist
  • Baxley, GA
National Provider Identifier
1669301750
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT008029 Issued in GA
Practice address
24 Glendale Ave Ste B
Baxley, GA 31513-0245
Phone
(912) 705-9952
Fax
(912) 705-2864
NPI assigned
May 15, 2026
Last updated
May 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT008029 GA Primary

Addresses

Primary practice location

24 Glendale Ave Ste B
Baxley, GA 31513-0245

Mailing address

24 Glendale Ave Ste B
Baxley, GA 31513-0245
Phone (912) 705-9952

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260603003600 GA Practitioner - Occupational Therapist in Private Practice 1759852478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

24 Glendale Ave
Suite B
Baxley, GA 31513-0244

418 Azalea Dr
Baxley, GA 31513-7044

4560 Courtland Cir
Hahira, GA 31632-2608

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT008029GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgecare Therapy Services LLC CurrentSince May 1, 2026 Accepting new patients

Locations

24 Glendale Ave
Ste B
Baxley, GA 31513
Phone (912) 705-9952

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": "1778803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1669301750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 GLENDALE AVE STE B",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315130245",
            "telephone_number": "912-705-9952",
            "fax_number": "912-705-2864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 GLENDALE AVE STE B",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315130245",
            "telephone_number": "912-705-9952",
            "fax_number": "912-705-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELTON",
        "first_name": "MARLEY",
        "middle_name": "MIKELL",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-15",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT008029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxley, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.