Individual provider Active NPI

Melani Macaraig

  • Physical Therapist
  • Mountain Grove, MO
National Provider Identifier
1861949992
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2016026054 Issued in MO
Practice address
1200 N Main St
#1
Mountain Grove, MO 65711-1025
Phone
(417) 926-5699
NPI assigned
Sep 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2016026054 MO Primary
Physical Therapist 225100000X 070.020677 IL

Addresses

Primary practice location

1200 N Main St
#1
Mountain Grove, MO 65711-1025

Mailing address

828 N Utah St
West Plains, MO 65775-2084
Phone (708) 228-6719

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

State licenses

LicenseStateTypeSpecialty
070.020677ILMDPhysical Therapist
2016026054MOMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1861949992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 N UTAH ST",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657752084",
            "telephone_number": "708-228-6719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N MAIN ST",
            "address_2": "#1",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "657111025",
            "telephone_number": "417-926-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACARAIG",
        "first_name": "MELANI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2016026054",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.020677",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Grove, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.

Verify at the official NPI Registry.