Individual provider Active NPI

Holly Ann Melvin, NBC-HWC

  • Health & Wellness Coach
  • Marion, IL
National Provider Identifier
1679147839
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health & Wellness CoachTaxonomy code 171400000X
License
A-3387622 Issued in IL
Practice address
1205 Aurelia Dr
Marion, IL 62959-5021
Phone
(618) 969-0634
NPI assigned
May 13, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness Coach 171400000X A-3387622 IL Primary

Addresses

Primary practice location

1205 Aurelia Dr
Marion, IL 62959-5021

Mailing address

1205 Aurelia Dr
Marion, IL 62959-5021
Phone (618) 969-0634

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

LicenseStateTypeSpecialty
A-3387622ILMDHealth & Wellness Coach

NPI Registry JSON

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

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1679147839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 AURELIA DR",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595021",
            "telephone_number": "618-969-0634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 AURELIA DR",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595021",
            "telephone_number": "618-969-0634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELVIN",
        "first_name": "HOLLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "NBC-HWC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-13",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "IL",
            "license": "A-3387622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; 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.