MELINDA MICHELLE CUSACK (NPI# 1932580909) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932580909 |
| Entity Type | Individual |
| Full Name | MELINDA MICHELLE CUSACK |
| Other Name | MELINDA MECHELLE MAILE |
| Credential | MD |
| Practice Address |
302 W Chestnut St Breckenridge MI 48615 |
| Mailing Address |
4000 Wellness Dr, Christie Bldg Midland MI 48670-2000 |
| Practice Telephone | 9898423118 |
| Practice Fax Number | 9898421110 |
| Mailing Telephone | 9898423118 |
| Mailing Fax Number | 9898421110 |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2019-10-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 4301500878 | MI | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 11018213A | IN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 4301111076 | MI | Student, Health Care |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 11018213A | IN | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 302 W Chestnut St, Breckenridge, MI 48615 | 9898423118 | 9898421110 |
| 4611 N Campus Ridge Dr, Midland, MI 486409533 | 9898393500 | 9898393344 |
| Street Address |
302 W CHESTNUT ST |
| City | BRECKENRIDGE |
| State | MI |
| Zip Code | 48615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518912971 | Heather Lynne Mata | Physician Assistant | 302 W Chestnut St, Breckenridge, MI 48615-9579 | 2006-05-24 |
| 1528347317 | Megan E Fondren | Physician Assistant | 302 W Chestnut St, Breckenridge, MI 48615-9579 | 2011-08-10 |
| 1013220573 | Scott C Kastning | Physician Assistant | 302 W Chestnut St, Breckenridge, MI 48615-9579 | 2010-07-26 |
| 1861555054 | Midmichigan Medical Center-gratiot | Clinic/Center | 302 W Chestnut St, Breckenridge, MI 48615-9579 | 2006-12-18 |
| 1922036912 | Nirmal B Patel | Family Medicine | 302 W Chestnut St, Breckenridge, MI 48615-9579 | 2006-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780759571 | Core Rehab LLC | Clinic/Center | 1987 W Pine River Rd, Breckenridge, MI 48615 | 2006-11-21 |
| 1487717625 | Jamie Jill Staley | Physical Therapist | 1987 W Pine River Rd, Breckenridge, MI 48615 | 2006-12-19 |
| 1487829545 | Alan Richard Hick | Dentist | 422 West Chestnut Street, Breckenridge, MI 48615-0241 | 2008-04-29 |
| 1821616798 | Brandon Tilson | Social Worker | 408 2nd St, Breckenridge, MI 48615-9544 | 2020-07-08 |
| 1376935080 | Alicia Witbrodt | Occupational Therapist | 5211 E Monroe Rd, Breckenridge, MI 48615-9575 | 2015-03-04 |
| 1710349717 | Hope Family Resources | Community/Behavioral Health | 4511 S Magrudder Rd, Breckenridge, MI 48615-9633 | 2016-03-28 |
| 1174055776 | Courtney Summers | Behavior Technician | 4511 S Magrudder Rd, Breckenridge, MI 48615-9633 | 2017-04-02 |
| 1831620335 | Ashley Phenix | Behavior Technician | 4511 S Magrudder Rd, Breckenridge, MI 48615-9633 | 2017-03-26 |
| 1619408549 | Marisa Colpetzer | Behavior Technician | 4511 S Magrudder Rd, Breckenridge, MI 48615-9633 | 2017-03-22 |
| 1548701196 | Megan Perry | Behavior Technician | 4511 S Magrudder Rd, Breckenridge, MI 48615-9633 | 2017-03-15 |
| Find all providers in zip 48615 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023629383 | Catholic Health Initiatives Colorado | Family Medicine | 400 N Park Ave Ste 1a, Breckenridge, CO 80424-8709 | 2020-08-11 |
| 1972811008 | Catholic Health Initiatives Colorado | Family Medicine | 555 S Park Ave, Plaza II, Breckenridge, CO 80424-0000 | 2010-09-23 |
| 1376682740 | Breckenridge Medical Clinic, LLC | Family Medicine | 555 South Park Avenue, Plaza 2, Breckenridge, CO 80424 | 2007-02-05 |
| 1780782672 | Breckenridge Family Clinic Pa | Family Medicine | 103 South Hartford Street, Breckenridge, TX 76424 | 2006-09-21 |
| 1871517193 | Shari J. Fitzgerald | Family Medicine | 1790 Airport Road, #b, Breckenridge, CO 80424 | 2006-07-27 |
| 1336125962 | Vladimir K Moskver | Family Medicine | 53 Audrey Cir, Breckenridge, CO 80424-8950 | 2005-12-15 |
| 1235135369 | Randall H. Nations | Family Medicine | 400 N Park Ave, # 1-a, Breckenridge, CO 80424 | 2005-06-23 |
| 1104246057 | Kelli Windsor | Family Medicine | 101 S Hartford St, Breckenridge, TX 76424-4711 | 2014-04-18 |
| 1184989642 | Susan Badidi | Family Medicine | 101 S Hartford St, Breckenridge, TX 76424-4711 | 2012-07-11 |
| 1497987812 | Jennifer L. Sheffield | Family Medicine | 2400 St Francis Dr, Breckenridge, MN 56520-1025 | 2009-08-18 |
| Find all providers in BRECKENRIDGE | ||||
| City | BRECKENRIDGE |
| Zip Code | 48615 |
Please comment or provide details below to improve the information on MELINDA MICHELLE CUSACK.
| 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.