Individual provider Active NPI

Antonette Melrose, RN

  • Registered Nurse
  • League City, TX
National Provider Identifier
1861090920
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
806003 Issued in TX
Practice address
3027 Marina Bay Dr Ste 344
League City, TX 77573-3089
Phone
(281) 968-2745
NPI assigned
Oct 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 806003 TX Primary

Addresses

Primary practice location

3027 Marina Bay Dr Ste 344
League City, TX 77573-3089

Mailing address

319 E Sterling St
Baytown, TX 77520-5135
Phone (832) 414-9499

Other names 1

  • Antonette Mapp Former name

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
806003TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
First Choice Childrens Homecare LP PastSince Oct 19, 2020 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1602460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1861090920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 E STERLING ST",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "775205135",
            "telephone_number": "832-414-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3027 MARINA BAY DR STE 344",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775733089",
            "telephone_number": "281-968-2745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELROSE",
        "first_name": "ANTONETTE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-12",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "806003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANTONETTE",
            "last_name": "MAPP",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in League City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; 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.