Active NPI
Melanie Edmonston Mabe, PNP
- Pediatric Nurse Practitioner
- Temple, TX
National Provider Identifier
1861614513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 574711
- Practice address
- 1901 SW H K Dodgen Loop
Temple, TX 76502-1814 - Phone
- (254) 724-2111
- NPI assigned
- May 3, 2007
- 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 574711 | TX | Primary |
Addresses
Primary practice location
1901 SW H K Dodgen Loop
Temple, TX 76502-1814
Mailing address
PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 191135602 | Medicaid | TX |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mmabe322268@direct.sw.org | Direct |
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)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lone Star Circle of Care | Past | Accepting new patients | |
| Magella Medical Associates Billing, Inc. | Past | Accepting new patients |
Interoperability endpoints
- mmabe322268@direct.sw.org
Organizations & group practices 2
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.
-
- Federally Qualified Health Center (FQHC)
- Austin, TX
- NPI 1699289728
-
- Neonatal-Perinatal Medicine Physician
- Round Rock, TX
- NPI 1083631071
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643241600000",
"number": "1861614513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 844658",
"city": "DALLAS",
"state": "TX",
"postal_code": "752844658",
"telephone_number": "254-724-2111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 SW H K DODGEN LOOP",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765021814",
"telephone_number": "254-724-2111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MABE",
"first_name": "MELANIE",
"middle_name": "EDMONSTON",
"credential": "PNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-03",
"last_updated": "2022-01-27",
"certification_date": "2022-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "TX",
"license": "574711",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "191135602",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mmabe322268@direct.sw.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1901 SW H K Dodgen Loop",
"city": "Temple",
"state": "TX",
"country_code": "US",
"postal_code": "765021814",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Temple, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.