Melissa Gayle Vavricka-Conaway

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1179 Issued in OK

Practice address

1001 N Country Club Rd
Ada, OK 74820-2847

Phone

(580) 421-4570

Fax

(580) 421-6283

NPI assigned

Mar 16, 2007

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

Enrolled in TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Chickasaw Nation Division of Health

  • General Acute Care Hospital
  • Ada, OK
  • NPI 1255364923

  TX

  Medicare reassignment NPD
• Chickasaw Nation Division of Health

  • Home Health Agency
  • Ada, OK
  • NPI 1811739071
  NPD
• Chickasaw Nation Division of Health

  • Primary Care Clinic/Center
  • Purcell, OK
  • NPI 1982764395
  NPD

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992839211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 N COUNTRY CLUB RD",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202847",
            "telephone_number": "580-421-4570",
            "fax_number": "580-421-6283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N COUNTRY CLUB RD",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202847",
            "telephone_number": "580-421-4570",
            "fax_number": "580-421-6283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAVRICKA-CONAWAY",
        "first_name": "MELISSA",
        "middle_name": "GAYLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "1179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "1179",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paula Elaine Vanbuskirk, DDS
• Lisa Vantriest-Peaden, LCSW
• George A Vascellaro, DO
• Anna Brooke Vass, PA-C
• Jarred Vaughan
• Pat Vavricka, CNM
• Christina Vega, CNM
• Lauren Mackenzie Vesely
• Charles R Vest, MD
• Luis H Vigil, M.D.

• All providers in Ada, OK
• Registered Dietitian in Oklahoma

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.