Active NPI
Melissa Mary Teller, AUD
- Audiologist
- Virginia Beach, VA
National Provider Identifier
1912436254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 2201001659
- Practice address
- 4360 Shore Dr Ste 101
Virginia Beach, VA 23455-2994 - Phone
- (757) 222-5062
- NPI assigned
- Jun 9, 2017
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 2201001659 | VA | Primary |
Addresses
Primary practice location
4360 Shore Dr Ste 101
Virginia Beach, VA 23455-2994
Mailing address
5800 Lake Wright Dr Ste 101
Norfolk, VA 23502-1804
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2201001659 | VA | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580774400000",
"number": "1912436254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5800 LAKE WRIGHT DR STE 101",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235021804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4360 SHORE DR STE 101",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234552994",
"telephone_number": "757-222-5062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TELLER",
"first_name": "MELISSA",
"middle_name": "MARY",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-09",
"last_updated": "2020-02-04",
"certification_date": "2020-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "VA",
"license": "2201001659",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.