Individual provider Active NPI

Melody Wilson Acosta, MPH RD

  • Pediatric Nutrition Registered Dietitian
  • Hood River, OR
National Provider Identifier
1760045793
Registry record updated Apr 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X
License
LD-D000480 Issued in OR
Practice address
811 13TH St
Hood River, OR 97031-1204
Phone
(541) 380-9059
NPI assigned
Apr 16, 2019
Last updated
Apr 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nutrition Registered Dietitian 133VN1004X LD-D000480 OR Primary

Addresses

Primary practice location

811 13TH St
Hood River, OR 97031-1204

Mailing address

811 13TH St
Hood River, OR 97031-1204
Phone (541) 380-9059

Other names 1

  • Melody Sue Wilson Former name

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

State licenses

LicenseStateTypeSpecialty
LD-D000480ORMDPediatric Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Columbia Medical Center CurrentSince Mar 20, 2020 Accepting new patients
Mid-Columbia Medical Center CurrentSince Mar 20, 2020 Accepting new patients
Healthcare for the Mid-Columbia Region Current Accepting new patients
Mid-Columbia Medical Center Past Accepting new patients

Locations

1700 E 19th St
The Dalles, OR 97058
Phone (541) 296-7251

1805 E 19th St
The Dalles, OR 97058
Phone (541) 296-2201

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1760045793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 13TH ST",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970311204",
            "telephone_number": "541-380-9059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 13TH ST",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970311204",
            "telephone_number": "541-380-9059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "MELODY",
        "middle_name": "WILSON",
        "credential": "MPH RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "OR",
            "license": "LD-D000480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELODY",
            "last_name": "WILSON",
            "middle_name": "SUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hood River, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; 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.