Active NPI
Michelle L. Mellion, MD
- Neurology Physician
- Providence, RI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- MD12012
- Practice address
- 2 Dudley St
Suite 555
Providence, RI 02905-3236 - Phone
- (401) 444-3032
- Fax
- (401) 444-3205
- NPI assigned
- Jun 6, 2006
- Last updated
- Feb 25, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | MD12012 | RI | Primary |
| Clinical Neurophysiology Physician | 2084N0600X | MD12012 | RI |
Addresses
Primary practice location
2 Dudley St
Suite 555
Providence, RI 02905-3236
Mailing address
2 Dudley St
Suite 555
Providence, RI 02905-3236
Phone (401) 444-3032
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MD12012 | Other | RI | MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD12012 | RI | MD | Clinical Neurophysiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rhode Island Hospital | Current | Accepting new patients | |
| Rhode Island Hospital | Neurology | Current | Accepting new patients |
| Rhode Island Hospital | Current | Accepting new patients | |
| Brown Neurology | Neurology | Past | Accepting new patients |
| Memorial Hospital | Past | Accepting new patients |
Locations
117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318
2 Dudley St
Ste 555
Providence, RI 02905
Phone (401) 444-4169
593 Eddy St
Providence, RI 02903
593 Eddy St
Ste 9B
Providence, RI 02903
Phone (401) 444-5280
Interoperability endpoints
- mmellion29881@tuftsmedicine.direct-ci.com
Organizations & group practices 5
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424822400000",
"number": "1780624262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 DUDLEY ST",
"address_2": "SUITE 555",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029053236",
"telephone_number": "401-444-3032",
"fax_number": "401-444-3205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 DUDLEY ST",
"address_2": "SUITE 555",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029053236",
"telephone_number": "401-444-3032",
"fax_number": "401-444-3205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELLION",
"first_name": "MICHELLE",
"middle_name": "L.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-06",
"last_updated": "2015-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "RI",
"license": "MD12012",
"primary": true
},
{
"code": "2084N0600X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Clinical Neurophysiology",
"state": "RI",
"license": "MD12012",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "MD12012",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.