Connie Ann Melton, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA152 Issued in KY

Practice address

1025 S 2ND St
Louisville, KY 40203-2823

Phone

(502) 584-2473

Fax

(502) 657-0228

NPI assigned

Jun 19, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942245253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87",
            "city": "DUPONT",
            "state": "IN",
            "postal_code": "472310087",
            "telephone_number": "812-273-3737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 S 2ND ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402032823",
            "telephone_number": "502-584-2473",
            "fax_number": "502-657-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELTON",
        "first_name": "CONNIE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50006904",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julio C Melo, MD
• Melody Prinkleton
• Chaawpohdeey Melody
• Daniel Seth Melson
• Cedaliah Melton, ARNP
• Katie Elizabeth Melton
• Michelle Erin Melton, APRN
• Sara Melton
• James Ross Melvin, DPT
• Karina Lynn Melvin, RN

• Medical Physician Assistant in Louisville, KY
• Providers in Louisville, KY by specialty
• Medical Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.