Organization Active NPI

Dr Melissa Sharp and Associates LTD

  • Adult Mental Health Clinic/Center
  • Saint Charles, IL
National Provider Identifier
1871892828
Registry record updated Apr 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
071006672 Issued in IL
Legal business name
DR MELISSA SHARP AND ASSOCIATES LTD
Practice address
1121 E Main St
Suite 405
Saint Charles, IL 60174-2205
Phone
(630) 777-6333
Fax
(630) 444-1407
NPI assigned
Mar 16, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2011

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

Authorized official

Name
Dr. Melissa Jane Sharp, PSYDNPI 1174530497
Title
Owner
Phone
(630) 777-6333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 071006672 IL Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 071006672 IL

Addresses

Primary practice location

1121 E Main St
Suite 405
Saint Charles, IL 60174-2205

Mailing address

1121 E Main St
Suite 405
Saint Charles, IL 60174-2205
Phone (630) 777-6333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110414000621 IL Part B Supplier - Clinic/Group Practice 1951585066 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Charles, IL

National Provider Directory

National Provider Directory

Locations

1121 E Main St
Ste 126
St Charles, IL 60174
Phone (630) 777-6333

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1300233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302739200000",
    "number": "1871892828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 E MAIN ST",
            "address_2": "SUITE 405",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601742205",
            "telephone_number": "630-777-6333",
            "fax_number": "630-444-1407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 E MAIN ST",
            "address_2": "SUITE 405",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601742205",
            "telephone_number": "630-777-6333",
            "fax_number": "630-444-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MELISSA SHARP AND ASSOCIATES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-16",
        "last_updated": "2011-04-14",
        "status": "A",
        "authorized_official_last_name": "SHARP",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-777-6333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "IL",
            "license": "071006672",
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "IL",
            "license": "071006672",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.