Nicholas Anthony Mellum, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4364 Issued in MN

Practice address

6640 Lyndale Ave S
Suite 120
Richfield, MN 55423-2323

Phone

(612) 866-1859

Fax

(612) 866-2404

NPI assigned

Aug 14, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 2002

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.

• Complete Chiropractic and Wellness, PA

  • Clinic/Center
  • Richfield, MN
  • NPI 1033325220
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831102870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6640 LYNDALE AVE S",
            "address_2": "SUITE 120",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232323",
            "telephone_number": "612-866-1859",
            "fax_number": "612-866-2404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6640 LYNDALE AVE S",
            "address_2": "SUITE 120",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232323",
            "telephone_number": "612-866-1859",
            "fax_number": "612-866-2404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLUM",
        "first_name": "NICHOLAS",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "088L3AS",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bertha Alicia Medina
• Patricia A Medina
• Yisakor Gemeda Megersa
• Leah Renee Meidt
• James P Mellema, MD
• Mending Mental Health
• Mepro Transport LLC
• Merciful Recovery Counseling & Coaching
• Mercy MN LLC
• Mercy Transportation

• Chiropractor in Richfield, MN
• Providers in Richfield, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.