NPIMap

Organization Active NPI

Melon Health

  • Prevention Professional
  • Hermosa Beach, CA
National Provider Identifier
1801470729
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prevention ProfessionalTaxonomy code 405300000X
Legal business name
MELON HEALTH
Practice address
624 24TH St
Hermosa Beach, CA 90254-2206
Phone
(720) 642-0459
NPI assigned
May 6, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Authorized official

Name
Mrs. Stormie S Baxter, CDCESNPI 1881199339
Title
Program Director
Phone
(720) 642-0459

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prevention ProfessionalGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 405300000X Primary

Addresses

Primary practice location

624 24TH St
Hermosa Beach, CA 90254-2206

Mailing address

624 24TH St
Hermosa Beach, CA 90254-2206
Phone (720) 642-0459

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1620259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620259200000",
    "number": "1801470729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 24TH ST",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902542206",
            "telephone_number": "720-642-0459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 24TH ST",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902542206",
            "telephone_number": "720-642-0459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELON HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-06",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A",
        "authorized_official_last_name": "BAXTER",
        "authorized_official_first_name": "STORMIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "720-642-0459",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CDCES"
    },
    "taxonomies": [
        {
            "code": "405300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Prevention Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermosa Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.