Individual provider Active NPI

Melinda Renee Meyer, PA-C

  • Physician Assistant
  • Johnson Cithy, TN
National Provider Identifier
1801132030
Registry record updated Nov 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA0000002348 Issued in TN
Practice address
401 East Main Street
Johnson Cithy, TN 37601-4877
Phone
(423) 929-2584
Fax
(423) 722-2060
NPI assigned
Dec 16, 2012
Last updated
Nov 18, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA0000002348 TN Primary

Addresses

Primary practice location

401 East Main Street
Johnson Cithy, TN 37601-4877

Mailing address

401 E Main St
Johnson City, TN 37601-4877
Phone (423) 929-2584

Other identifiers 1

IdentifierTypeStateIssuer
2348OtherTNLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131209000282 TN Practitioner - Physician Assistant 7416184932 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA0000002348TNMDPhysician Assistant

Organizations & group practices 1

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": "1355616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384732800000",
    "number": "1801132030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E MAIN ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376014877",
            "telephone_number": "423-929-2584",
            "fax_number": "423-722-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 EAST MAIN STREET",
            "city": "JOHNSON CITHY",
            "state": "TN",
            "postal_code": "376014877",
            "telephone_number": "423-929-2584",
            "fax_number": "423-722-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "MELINDA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-16",
        "last_updated": "2013-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA0000002348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2348",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.