Individual provider Active NPI

Robyn Mellang

  • Occupational Therapist
  • Sioux City, IA
National Provider Identifier
1891184255
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
073264 Issued in IA
Practice address
5114 Bushnell Ave
Sioux City, IA 51106-3737
Phone
(605) 691-5093
NPI assigned
Jan 22, 2015
Last updated
Jun 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 073264 IA Primary

Addresses

Primary practice location

5114 Bushnell Ave
Sioux City, IA 51106-3737

Mailing address

5114 Bushnell Ave
Sioux City, IA 51106-3737
Phone (605) 691-5093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, SD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150504001196 IA Practitioner - Occupational Therapist in Private Practice 9234458852 Reassigns benefits to 2 organizations
I20201106002041 SD Practitioner - Occupational Therapist in Private Practice 9234458852 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2441NEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health Network Current Accepting new patients
Sanford Health Network CurrentSince Mar 10, 2015 Accepting new patients
Sanford Health Network CurrentSince Mar 10, 2015 Accepting new patients

Locations

118 N 7th Ave
Sheldon, IA 51201
Phone (712) 324-5041

800 Oak St
Sheldon, IA 51201
Phone (712) 324-5356

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1891184255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5114 BUSHNELL AVE",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511063737",
            "telephone_number": "605-691-5093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5114 BUSHNELL AVE",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511063737",
            "telephone_number": "605-691-5093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLANG",
        "first_name": "ROBYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-22",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": "073264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.