Active NPI
Melinda Poteet Green, NBCOT, COTA
- Occupational Therapy Assistant
- High Rolls Mountain Park, NM
National Provider Identifier
1972096881
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 3600
- Practice address
- PO Box 503
High Rolls Mountain Park, NM 88325-0503 - Phone
- (979) 820-0562
- NPI assigned
- Jun 14, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 3600 | NM | Primary |
Addresses
Primary practice location
PO Box 503
High Rolls Mountain Park, NM 88325-0503
Mailing address
PO Box 503
High Rolls Mountain Park, NM 88325-0503
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 |
|---|---|---|---|
| 3600 | NM | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528934400000",
"number": "1972096881",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 503",
"city": "HIGH ROLLS MOUNTAIN PARK",
"state": "NM",
"postal_code": "883250503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX 503",
"city": "HIGH ROLLS MOUNTAIN PARK",
"state": "NM",
"postal_code": "883250503",
"telephone_number": "979-820-0562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "MELINDA",
"middle_name": "POTEET",
"credential": "NBCOT, COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-14",
"last_updated": "2018-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NM",
"license": "3600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in High Rolls Mountain Park, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.