Active NPI
Alice J Mellow
- Chiropractor
- West Palm Beach, FL
National Provider Identifier
1750596706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH0004029
- Practice address
- 4541 Willow Pond CT E
West Palm Beach, FL 33417-8243 - Phone
- (561) 346-1663
- Fax
- (954) 481-9641
- NPI assigned
- May 13, 2007
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH0004029 | FL | Primary |
Addresses
Primary practice location
4541 Willow Pond CT E
West Palm Beach, FL 33417-8243
Mailing address
4541 Willow Pond CT E
West Palm Beach, FL 33417-8243
Phone (561) 346-1663
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 88919A | Other | FL | BLUE CROSS |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rait Health Center, P.a. | Chiropractor | Past | Accepting new patients |
| Rait Health Center, P.a. | Chiropractor | 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.
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- Lake Worth, FL
- NPI 1912268194
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750596706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4541 WILLOW POND CT E",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334178243",
"telephone_number": "561-346-1663",
"fax_number": "954-481-9641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4541 WILLOW POND CT E",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334178243",
"telephone_number": "561-346-1663",
"fax_number": "954-481-9641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELLOW",
"first_name": "ALICE",
"middle_name": "J",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH0004029",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "88919A",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.