Individual provider Active NPI

Thomas Charles Melah, REGISTERED NURSE

  • Registered Nurse
  • Fitchburg, WI
National Provider Identifier
1679715106
Registry record updated Mar 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
102541-030 Issued in WI
Practice address
2570 Roanoke Cir
Fitchburg, WI 53719-1662
Phone
(606) 276-8955
Fax
(608) 276-8955
NPI assigned
Mar 30, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 102541-030 WI Primary

Addresses

Primary practice location

2570 Roanoke Cir
Fitchburg, WI 53719-1662

Mailing address

2570 Roanoke Cir
Fitchburg, WI 53719-1662
Phone (606) 276-8955

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
102541-030WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238371200000",
    "number": "1679715106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 ROANOKE CIR",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537191662",
            "telephone_number": "606-276-8955",
            "fax_number": "608-276-8955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 ROANOKE CIR",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537191662",
            "telephone_number": "606-276-8955",
            "fax_number": "608-276-8955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELAH",
        "first_name": "THOMAS",
        "middle_name": "CHARLES",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-30",
        "last_updated": "2009-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "102541-030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitchburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; 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.