Allie McKenzie Melvin, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

057.005858 Issued in IL

Practice address

1700 White St
Mount Vernon, IL 62864-4349

Phone

(618) 242-4075

Fax

(618) 242-4092

NPI assigned

Aug 25, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1891414520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 S MADISON ST",
            "city": "DU QUOIN",
            "state": "IL",
            "postal_code": "628322432",
            "telephone_number": "618-242-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 WHITE ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628644349",
            "telephone_number": "618-242-4075",
            "fax_number": "618-242-4092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELVIN",
        "first_name": "ALLIE",
        "middle_name": "MCKENZIE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-25",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057.005858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea McMahon, MA
• Kent McMahon, D.C.
• Madison Jade McWhorter
• Amanda Lynne Meadows
• Doris Meadows, RNFA
• Ashley Ann Melvin, MHP
• Teresa L Mendenhall, RN
• Kinny Merchant, OT
• Mid America Radiology SC
• Midwest Emergency Good Samaritan

• Occupational Therapy Assistant in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Occupational Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.

Verify at the official NPI Registry.