Individual provider Active NPI

Jon Meliones, MD

  • Pediatric Critical Care Medicine Physician
  • Durham, NC
National Provider Identifier
1710067715
Registry record updated Dec 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
0000-35169 Issued in NC
Practice address
2100 Erwin Rd
Durham, NC 27710-0001
Phone
(919) 684-8111
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 0000-35169 NC Primary

Addresses

Primary practice location

2100 Erwin Rd
Durham, NC 27710-0001

Mailing address

6431 Fannin St
Houston, TX 77030-1501
Phone (919) 641-8204

Other practice location 1

6431 Fannin St
Houston, TX 77030-1501
Phone (919) 641-8204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171206002275 TX Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology)Practitioner - Critical Care (Intensivists) 8820089659 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0000-35169NCMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Sep 1, 2017 Accepting new patients
Ut Physicians CurrentSince Sep 1, 2017 Accepting new patients
Memorial Hermann Health System Past Accepting new patients
University of North Carolina at Chapel Hill Past Accepting new patients

Locations

1515 Holcombe Blvd
Houston, TX 77030
Phone (713) 794-5446

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

1515 Holcombe Blvd
#R4212
Houston, TX 77030
Phone (713) 794-5446

1515 Holcombe Blvd
#M
Houston, TX 77030
Phone (713) 792-6127

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

6431 Fannin St
Houston, TX 77030
Phone (713) 500-5800

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607731200000",
    "number": "1710067715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "919-641-8204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 ERWIN RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277100001",
            "telephone_number": "919-684-8111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6431 Fannin St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770301501",
            "country_code": "US",
            "telephone_number": "919-641-8204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELIONES",
        "first_name": "JON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2020-12-12",
        "certification_date": "2020-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NC",
            "license": "0000-35169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.