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MELINDA MCCLENDON RN AGNP-BC NPI 1003212184


NPI Information

NPI: 1003212184
Provider Name: MELINDA MCCLENDON, RN, AGNP-BC
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

Organization: POUDRE VALLEY MEDICAL GROUP LLC

PECOS Registration: Yes

Address:
4110 BRIARGATE PKWY STE 405
COLORADO SPRINGS, CO
ZIP 80920
Phone: (719) 365-7300
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Melinda Mcclendon, RN, AGNP-BC is a gerontology nurse practitioner in Colorado Springs, CO with 8 years of experience. Melinda Mcclendon, RN, AGNP-BC NPI is 1003212184. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4110 BRIARGATE PKWY STE 405
COLORADO SPRINGS, CO
ZIP 80920-838
Phone: (719) 365-7300
Fax: (512) 275-2833

The NPI 1003212184 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/17/2014 and was last updated on 2/3/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363L00000XNurse PractitionerAP126900TEXASNo
2363LA2200XNurse PractitionerAdult HealthAP126900TEXASNo
3363LG0600XNurse PractitionerGerontologyAP126900TEXASNo
4363LG0600XNurse PractitionerGerontologyC-APN.0000696-C-NPCOLORADOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1341829502MEDICAIDTEXAS
2341829501MEDICAIDTEXAS
39000145106MEDICAIDCOLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/15/2022

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.