Melissa M. Blair, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

3005 James Ave S
Minneapolis, MN 55408-2533

Phone

(612) 227-2829

Fax

(612) 377-7501

NPI assigned

Dec 2, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• James Avenue Psychological Consultation, P.a.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Minneapolis, MN
  • NPI 1407924780

  Clinical Child & Adolescent

  NPD Authorized official

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

{
    "created_epoch": "1165017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1962570242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3005 JAMES AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082589",
            "telephone_number": "612-227-2829",
            "fax_number": "612-377-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 JAMES AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082533",
            "telephone_number": "612-227-2829",
            "fax_number": "612-377-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "MELISSA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-02",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MN",
            "license": "LP3550",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040161700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA OR UBH",
            "identifier": "6173818",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "117T6NA OR 114T7NA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BHP",
            "identifier": "20258-11",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "141774",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle M Blaeser, MD
• Alen Blagajcevic, DMD
• Melanie Marie Blahnik, PSY.D.
• Gretchen Blain
• Jennifer C Blair, L.AC.
• Sidney Blair
• Kristina Marie Blaiser, MA, CCC- SLP
• Nathan Thomas Blake, PHARM. D.
• Paul Blake
• Timothy G Blake, LP

• Psychologist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.