Melissa Renae Justice, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0119002439 Issued in VA

Practice address

613 Bridgeway Dr
Maryville, TN 37801-8545

Phone

(606) 205-0350

NPI assigned

Aug 4, 2016

Last updated

Mar 12, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Other names 1

• Melissa Renae Justice-West Other name

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Functional Pathways Preferred of Tennessee LLC

  • Physical Therapist
  • Knoxville, TN
  • NPI 1841561446

  NC

  Medicare reassignment

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

{
    "created_epoch": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1790239069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 BRIDGEWAY DR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378018545",
            "telephone_number": "606-205-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 BRIDGEWAY DR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378018545",
            "telephone_number": "606-205-0350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTICE",
        "first_name": "MELISSA",
        "middle_name": "RENAE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-04",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "123815",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "16227",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WV",
            "license": "1605",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "135505",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "7256",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119002439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "JUSTICE-WEST",
            "middle_name": "RENAE",
            "credential": "OTR/L",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shawnee Joslin, MS CCC-SLP
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• Nadim J Jubran, DDS
• Virginia Juern, FNP
• Jackie Leanne Justice
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• Tara Kadunce
• Brooke Kambic
• Gavin Grace Kane, LMSW

• Occupational Therapist in Maryville, TN
• Providers in Maryville, TN by specialty
• Occupational Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.