DR. JENNIFER REBECCA MELLICK (NPI# 1093712903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093712903 |
| Entity Type | Individual |
| Full Name | DR. JENNIFER REBECCA MELLICK |
| Credential | M.D. |
| Practice Address |
7301 W 133rd St Suite 102 Overland Park KS 66213-4750 |
| Practice Telephone | 9138884567 |
| Practice Fax Number | 9138881277 |
| Mailing Telephone | 9138884567 |
| Mailing Fax Number | 9138881277 |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2011-12-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
04-30373 | KS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | BCBSKC PROVIDER NUMBER | 33978014 | 01 |
| Street Address |
7301 W 133RD ST SUITE 102 |
| City | OVERLAND PARK |
| State | KS |
| Zip Code | 66213-4750 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427056126 | Michael Alan Blum | Pediatrics | 7301 W 133rd St, Suite 102, Overland Park, KS 66213-4750 | 2005-07-07 |
| 1366768640 | Peter John Carter | Pediatrics | 7301 W 133rd St, Suite 102, Overland Park, KS 66213-4750 | 2010-04-12 |
| 1780834663 | Amy Christine Bakken | Nurse Practitioner | 7301 W 133rd St, Suite 102, Overland Park, KS 66213-4750 | 2008-09-26 |
| 1386849172 | Susan Louise Ratliff | Pediatrics | 7301 W 133rd St, Suite 102, Overland Park, KS 66213-4750 | 2007-06-20 |
| 1609946383 | Pediatric Partners,p.a. | Pediatrics | 7301 W 133rd St, Suite 102, Overland Park, KS 66213-4750 | 2006-11-09 |
| 1457307027 | The Rehabilitation Institute of Kansas City | Clinic/Center | 7301 W 133rd St, Suite 102, Overland Park, KS 66213-4750 | 2006-05-25 |
| 1487651394 | Kristen Kasper Stuppy | Pediatrics | 7301 W 133rd St, Suite 102, Overland Park, KS 66213-4750 | 2005-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003345372 | Nicole Renee Oliphant | Speech-Language Pathologist | 12810 W 133 Pl Apt 3109, Overland Park, KS 66213 | 2017-06-08 |
| 1770026874 | Alyssa Potter | Physical Therapy Assistant | 12202 Goodman St, Overland Park, KS 66213 | 2016-11-22 |
| 1164809380 | Jessica Richter | Family Medicine | 10100 W 119th St Ste 150, Overland Park, KS 66213 | 2015-04-27 |
| 1891180816 | Naresh Kumar Dugal | Podiatrist | 13410 Westgate St Apt 2110, Overland Park, KS 66213 | 2015-04-06 |
| 1801219456 | Denise Ahnen | Lactation Consultant, Non-RN | 121300 Metcalf Ave, Overland Park, KS 66213 | 2014-01-31 |
| 1407294986 | Blue Valley Asc, P.a. | Clinic/Center | 12800 Metcalf Avenue Suite 2, Overland Park, KS 66213 | 2013-06-06 |
| 1023455326 | Duncan Arnold Killen | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 12542 W. 123rd Terr., Overland Park, KS 66213 | 2013-05-28 |
| 1821432345 | Seniorbridge Family Companies (mo), Inc. | In Home Supportive Care | 7304 W. 130th Street, Suite 100, Overland Park, KS 66213 | 2013-04-26 |
| 1538427273 | Charles E Emms D.c., Pa | Chiropractor | 11960 West 119th Street, 11960, Overland Park, KS 66213 | 2012-05-01 |
| 1194000570 | Phoenix Healthcare Clinic | Family Medicine | 11960 Quivira Road, Suite #100, Overland Park, KS 66213 | 2011-10-17 |
| Find all providers in zip 66213 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427056126 | Michael Alan Blum | Pediatrics | 7301 W 133rd St, Suite 102, Overland Park, KS 66213-4750 | 2005-07-07 |
| 1932425378 | Michaela Marie Voss | Pediatrics | 5808 W 110th St, Overland Park, KS 66211-2504 | 2010-04-09 |
| 1487651394 | Kristen Kasper Stuppy | Pediatrics | 7301 W 133rd St, Suite 102, Overland Park, KS 66213-4750 | 2005-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962548883 | Kansas University Physicians Inc | Pediatrics | 2026 Hc Miller, Mail Stop 4004 3901 Rainbow Blvd, Kansas City, KS 66160 | 2007-01-29 |
| 1962503839 | Patsy Barker Md Pa | Pediatrics | 315 N Hillside St Ste B, Wichita, KS 67214-4915 | 2006-09-25 |
| 1275508723 | O. Keith Enlow | Pediatrics | 824 W Frontier Ln, Olathe, KS 66061-7216 | 2006-02-20 |
| 1497025993 | Marged L Amend | Pediatrics | 1225 Rural St, Emporia, KS 66801-5539 | 2011-12-31 |
| 1285719807 | Steven Joseph Haug | Pediatrics | 1133 College Ave, Ste G-210, Manhattan, KS 66502-2770 | 2006-10-25 |
| 1942385653 | Graham Clifton Rose | Pediatrics | 1133 College Ave, Ste E-220, Manhattan, KS 66502-2770 | 2006-10-25 |
| 1275618993 | Greg A Biberstein | Pediatrics | 1133 College Ave, Ste E-220, Manhattan, KS 66502-2770 | 2006-10-25 |
| 1629153259 | Robert Mark Duff | Pediatrics | 1133 College Ave, Ste G-210, Manhattan, KS 66502-2770 | 2006-10-25 |
| 1770668311 | Jason R Gallagher | Pediatrics | 1133 College Ave, Ste G-210, Manhattan, KS 66502-2770 | 2006-10-25 |
| 1083799621 | Rebecca S Klingler | Pediatrics | 1133 College Ave, Ste G-210, Manhattan, KS 66502-2770 | 2006-10-25 |
| Find all providers with the same taxonomy | ||||
| City | OVERLAND PARK |
| Zip Code | 66213 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.