Active NPI
Melina Wilson, MS-CCC-SLP
- Speech-Language Pathologist
- Pine Bush, NY
National Provider Identifier
1710477302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 028805-1
- Practice address
- 7 Van Keuren Ave
Pine Bush, NY 12566-6621 - Phone
- (845) 313-9110
- NPI assigned
- May 18, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 028805-1 | NY | Primary |
Addresses
Primary practice location
7 Van Keuren Ave
Pine Bush, NY 12566-6621
Mailing address
75 Crystal Run Road
Suite 201
Middletown, NY 10941
Phone (845) 692-4391
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 |
|---|---|---|---|
| 028805-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635120000000",
"number": "1710477302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 CRYSTAL RUN ROAD",
"address_2": "SUITE 201",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "10941",
"telephone_number": "845-692-4391",
"fax_number": "845-692-4397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 VAN KEUREN AVE",
"city": "PINE BUSH",
"state": "NY",
"postal_code": "125666621",
"telephone_number": "845-313-9110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "MELINA",
"credential": "MS-CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-18",
"last_updated": "2021-10-25",
"certification_date": "2021-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "028805-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pine Bush, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.