Gregory Allen Melder, SA-C

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

14-576

Practice address

2751 Albert L Bicknell Dr Ste 3a
Shreveport, LA 71103-3976

Phone

(318) 636-9905

Fax

(318) 636-5102

NPI assigned

Nov 18, 2014

Sex

Male

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

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.

• Norwood Surgical Specialists, LLC

  • Surgery Physician
  • Shreveport, LA
  • NPI 1790836781
  NPD (past)

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

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416355200000",
    "number": "1740686740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3858",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711333858",
            "telephone_number": "318-636-9905",
            "fax_number": "318-636-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 ALBERT L BICKNELL DR STE 3A",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033976",
            "telephone_number": "318-636-9905",
            "fax_number": "318-636-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELDER",
        "first_name": "GREGORY",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "SA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-18",
        "last_updated": "2014-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": "14-576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vikas Mehta, M.D.
• Vijayashree Mekala, M.D.
• Glynn R Melancon, O.T.
• Tempestt Melancon
• Melanie C Frederick
• Claire Marie Melebeck, PT
• Mariah Corbell Meleton, LOTR
• Melissa L Lynn MD Apmc
• Dorothy L Mellon, M.D.
• Aja Welch Menard, M.D.

• Surgical Assistant in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Surgical Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.

Verify at the official NPI Registry.