Gary A. Mellick, D.O.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

02006613A Issued in IN

Practice address

2525 W University Ave Ste 502
Muncie, IN 47303-3409

Phone

(765) 751-2600

NPI assigned

Apr 26, 2006

Last updated

Jan 14, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 7

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AL, SD2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gmellick@direct.iuhealth.org
• Direct secure messaging: gmellick@yourcarecommunity.org

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.

• Fort Payne Clinic Corp.

  • Internal Medicine Physician
  • Fort Payne, AL
  • NPI 1396764395
  Medicare reassignment NPD
• Monument Health Rapid City Hospital, Inc

  dba Monument Health Behavioral Health Center

  • Multi-Specialty Clinic/Center
  • Rapid City, SD
  • NPI 1275553463
  Medicare reassignment NPD
• Indiana University Health Ball Memorial Physicians, Inc.

  • Family Medicine Physician
  • Muncie, IN
  • NPI 1235455544
  NPD
• Fort Payne Clinic Corp

  dba Dekalb Orthopedics & Sports Medicine

  • Durable Medical Equipment & Medical Supplies
  • Fort Payne, AL
  • NPI 1326521345
  NPD
• Monument Health Rapid City Hospital Inc

  dba Monument Health Rapid Valley Clinic

  • Urgent Care Clinic/Center
  • Rapid City, SD
  • NPI 1215727854
  NPD
• Monument Health Rapid City Hospital Inc

  dba Monument Health Medical Clinic - Rapid City Ear, Nose, Throat

  • Clinic/Center
  • Rapid City, SD
  • NPI 1437860954
  NPD
• Gadsden Hma Physician Management, LLC

  • Certified Registered Nurse Anesthetist
  • Gadsden, AL
  • NPI 1073781514
  NPD (past)
• Neurological Associates of the South, LLC

  • Specialist
  • Waycross, GA
  • NPI 1174578553
  NPD (past)

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1780641506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 W UNIVERSITY AVE STE 502",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473033409",
            "telephone_number": "765-751-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 Medical Center Dr SW",
            "address_purpose": "LOCATION",
            "city": "Fort Payne",
            "state": "AL",
            "postal_code": "359683420",
            "country_code": "US",
            "telephone_number": "256-845-0345",
            "fax_number": "256-845-0375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELLICK",
        "first_name": "GARY",
        "middle_name": "A.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2022-01-14",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "055142",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "34004503",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "02006613A",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AL",
            "license": "DO1117",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "AL",
            "license": "DO1117",
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "AL",
            "license": "DO1117",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "AL",
            "license": "DO1117",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078521",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmellick@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2525 W University Ave Ste 502",
            "city": "Muncie",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473033409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cale Jeffrey Melham
• Lynnea Melham, RDN
• Thomas J Melham, MD
• Melissa Osner Counseling, LLC
• Paul F Mellen, M.D.
• Emmanuel Melonakos, MD
• Kelcie Nicole Mendenhall
• Jose Marco Julian Ja Ruiz de Luzuriaga Mendezona, MD
• Thomas P Mengelt, MD
• Steven Menifee, PEER RECOVERY COACH

• Neurology Physician in Muncie, IN
• Providers in Muncie, IN by specialty
• Neurology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; 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.

Verify at the official NPI Registry.