Organization Active NPI

Wellpsyche, Inc.

  • Psychologist
  • Rome, GA
National Provider Identifier
1992939201
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
WELLPSYCHE, INC.
Practice address
501 Broad St Ste 306
Rome, GA 30161-3096
Phone
(706) 232-8330
Fax
(844) 873-4760
NPI assigned
May 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Authorized official

Name
Dr. Shanna Melton, PSY.D.NPI 1851432058
Title
Owner/Psychologist
Phone
(706) 232-8330

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

501 Broad St Ste 306
Rome, GA 30161-3096

Mailing address

501 Broad St Ste 306
Rome, GA 30161-3096
Phone (706) 232-8330

Other identifiers 1

IdentifierTypeStateIssuer
434425435DMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230804003704 GA Part B Supplier - Clinic/Group Practice 2668833740 Receives reassigned benefits from 1 practitioner
Practice locations: Rome, GA

National Provider Directory

National Provider Directory

Locations

501 Broad St
Ste 306
Rome, GA 30161
Phone (678) 235-5790

106 E 5th Ave
Rome, GA 30161
Phone (706) 232-8330

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1242259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687305600000",
    "number": "1992939201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 BROAD ST STE 306",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301613096",
            "telephone_number": "706-232-8330",
            "fax_number": "844-873-4760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 BROAD ST STE 306",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301613096",
            "telephone_number": "706-232-8330",
            "fax_number": "844-873-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLPSYCHE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-14",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A",
        "authorized_official_last_name": "MELTON",
        "authorized_official_first_name": "SHANNA",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "706-232-8330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "434425435D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; 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.