Active NPI
Lynn Anne Melickian, O.T.R.
- Occupational Therapist
- San Diego, CA
National Provider Identifier
1710127337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 13150
- Practice address
- 3020 Children'S Way MC 5068
San Diego, CA 92123 - Phone
- (858) 966-5829
- Fax
- (858) 966-5859
- NPI assigned
- Feb 22, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 13150 | CA | Primary |
| Pediatric Occupational Therapist | 225XP0200X | 002945-1 | NY | |
| Pediatric Occupational Therapist | 225XP0200X | 13150 | CA |
Addresses
Primary practice location
3020 Children'S Way MC 5068
San Diego, CA 92123
Mailing address
3020 Children'S Way MC 5068
San Diego, CA 92123
Phone (858) 966-5829
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
| License | State | Type | Specialty |
|---|---|---|---|
| 002945-1 | NY | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rady Children'S Hospital San Diego | Past | Accepting new patients | |
| Rady Children'S Hospital San Diego | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Children's Rehabilitation Hospital
- San Diego, CA
- NPI 1174907216
-
- Children's Rehabilitation Hospital
- San Diego, CA
- NPI 1184008229
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411516800000",
"number": "1710127337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3020 CHILDREN'S WAY MC 5068",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92123",
"telephone_number": "858-966-5829",
"fax_number": "858-966-5859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3020 CHILDREN'S WAY MC 5068",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92123",
"telephone_number": "858-966-5829",
"fax_number": "858-966-5859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELICKIAN",
"first_name": "LYNN",
"middle_name": "ANNE",
"credential": "O.T.R.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-22",
"last_updated": "2014-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "13150",
"primary": true
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "NY",
"license": "002945-1",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "CA",
"license": "13150",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.