Active NPI
Melissa Kletz
- Pharmacist
- Winamac, IN
National Provider Identifier
1962005827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26021143A
- Practice address
- 850 N Plymouth Rd
Winamac, IN 46996-1124 - Phone
- (574) 946-3554
- NPI assigned
- Nov 20, 2020
- Last updated
- Nov 20, 2020
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26021143A | IN | Primary |
Addresses
Primary practice location
850 N Plymouth Rd
Winamac, IN 46996-1124
Mailing address
850 N Plymouth Rd
Winamac, IN 46996-1124
Phone (574) 946-3554
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 |
|---|---|---|---|
| 26021143A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hook-Superx LLC | Past | Accepting new patients |
Organizations & group practices 1
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": "1605830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605830400000",
"number": "1962005827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 N PLYMOUTH RD",
"city": "WINAMAC",
"state": "IN",
"postal_code": "469961124",
"telephone_number": "574-946-3554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 N PLYMOUTH RD",
"city": "WINAMAC",
"state": "IN",
"postal_code": "469961124",
"telephone_number": "574-946-3554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLETZ",
"first_name": "MELISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-20",
"last_updated": "2020-11-20",
"certification_date": "2020-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26021143A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winamac, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.