Active NPI
Jessica Mella
- Registered Dietitian
- Sheboygan, WI
National Provider Identifier
1821457524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 3100 Superior Ave
Sheboygan, WI 53081-1948 - Phone
- (920) 459-5192
- NPI assigned
- Feb 23, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
3100 Superior Ave
Sheboygan, WI 53081-1948
Mailing address
3100 Superior Ave
Sheboygan, WI 53081-1948
Phone (920) 459-5192
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1320 | Other | WI | LICENSE# |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456185600000",
"number": "1821457524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 SUPERIOR AVE",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530811948",
"telephone_number": "920-459-5192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 SUPERIOR AVE",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530811948",
"telephone_number": "920-459-5192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELLA",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-23",
"last_updated": "2016-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE#",
"identifier": "1320",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sheboygan, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.