NPI Code Detail JSON Logo

1295031128 NPI number — MELISSA L POUNDERS NP-C

NPI Number: 1295031128
Health Care Provider/Practitioner: MELISSA L POUNDERS NP-C

Information about “1295031128” NPI (MELISSA L POUNDERS NP-C) exists in 1295031128 in HTML format HTML  |  1295031128 in plain Text format TXT  |  1295031128 in PDF (Portable Document Format) PDF  |  1295031128 in an XML format XML  formats.

NPI Number : 1295031128 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1295031128",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "POUNDERS",
    "FirstName": "MELISSA",
    "MiddleName": "L",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "NP-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SRYGLEY",
    "OtherFirstName": "MELISSA",
    "OtherMiddleName": "L",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "NP-C",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1025 S 6TH ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SPRINGFIELD",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "62703-2403",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "217-528-7541",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "515 E GRANT ST STE 211",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MACOMB",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "61455-3378",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "309-836-3387",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/10/2011",
    "LastUpdateDate": "06/03/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": "209008450",
        "LicenseNumberStateCode": "IL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.