Melanie Ann Pethtel, QMHS3

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

336 E Main St
Jackson, OH 45640-1718

Phone

(740) 688-2586

NPI assigned

Feb 28, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/pathihc/r4/

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.

• Phoenix Group Home, LLC

  • Community/Behavioral Health Agency
  • Portsmouth, OH
  • NPI 1083146013
  NPD (past)
• Phoenix Group Home, LLC

  • Substance Abuse Rehabilitation Facility
  • Cincinnati, OH
  • NPI 1336654854
  NPD (past)

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

{
    "created_epoch": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1710488325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W MAIN ST",
            "city": "CIRCLEVILLE",
            "state": "OH",
            "postal_code": "431131654",
            "telephone_number": "740-773-4366",
            "fax_number": "740-775-7855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 E MAIN ST",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456401718",
            "telephone_number": "740-688-2586"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Burlington Rd",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "OH",
            "postal_code": "456409360",
            "country_code": "US",
            "telephone_number": "740-286-5075",
            "fax_number": "740-395-8411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETHTEL",
        "first_name": "MELANIE",
        "middle_name": "ANN",
        "credential": "QMHS3",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-28",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Perry Physical Therapy
• John B Perry, PT
• Michelle Perry, APRN
• Katelyn May Pessia, RPH
• Eugenia Ann Peterson, APRN
• Kimberly Ann Phillips, LPN
• Rachel Lauren Piccin, PHARMD, RPH
• Rodney Pickell
• Bobby Lee Pierce, CMA
• Anthony J. Polcyn, PT

• Case Manager/Care Coordinator in Jackson, OH
• Providers in Jackson, OH by specialty
• Case Manager/Care Coordinator in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.