Melissa Child

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LMSW-40310 Issued in ID

Practice address

3765 US-20
Island Park, ID 83429

Phone

(208) 549-9970

NPI assigned

Jan 6, 2021

Last updated

Dec 1, 2023By 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 1

Addresses

Other names 1

• Melissa Jacobe Former name

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Integrated Wellness, LLC

  • Social Worker
  • Island Park, ID
  • NPI 1982470811
  NPD Authorized official
• Eastunder Therapy LLC

  dba Meraki Healthcare

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Idaho Falls, ID
  • NPI 1447939129
  NPD
• Alpine Physical Therapy PLLC

  • Physical Therapist
  • Ashton, ID
  • NPI 1780956292
  NPD (past)

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

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1811585771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2184 CHANNING WAY # 248",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048034",
            "telephone_number": "253-279-7924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3765 US-20",
            "city": "ISLAND PARK",
            "state": "ID",
            "postal_code": "83429",
            "telephone_number": "208-549-9970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2036 Lincoln Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Ogden",
            "state": "UT",
            "postal_code": "844016516",
            "country_code": "US",
            "telephone_number": "253-279-7924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHILD",
        "first_name": "MELISSA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-06",
        "last_updated": "2023-12-01",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW-40310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "JACOBE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jonathan Matthew Bunney
• Fremont Medical Services PC
• Integrated Wellness, LLC
• Jeremy Chad Rindlisbacher, PA-C

• Social Worker in Island Park, ID
• Providers in Island Park, ID by specialty
• Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.