Melinda Rae Viktoria Black

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

License

A-3969671 Issued in UT

Practice address

4518 Caddie LN
Highland, UT 84003-9552

Phone

(801) 709-3944

NPI assigned

Sep 26, 2024

Last updated

Sep 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1727308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1982422267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4518 CADDIE LN",
            "city": "HIGHLAND",
            "state": "UT",
            "postal_code": "840039552",
            "telephone_number": "801-709-3944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4518 CADDIE LN",
            "city": "HIGHLAND",
            "state": "UT",
            "postal_code": "840039552",
            "telephone_number": "801-709-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "MELINDA",
        "middle_name": "RAE VIKTORIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-26",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "UT",
            "license": "A-3969671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Jean Barney, APRN
• Christopher James Bates, D.M.D.
• Paulette T Benson, R.PH.
• Katherine Biggs, MD, PHARMD
• Alyssa Nicole Black, LCSW
• David Howarth Blackwell, LPC, LSAC
• Blue Cherries II LLC
• Blue Pine Ai LLC
• Don Rees Boren, D.D.S.
• Jeanne Marie Borget, APRN

• Health & Wellness Coach in Highland, UT
• Providers in Highland, UT by specialty
• Health & Wellness Coach in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.