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
Get Directions

Melinda Mcclendon, RN, AGNP-BC is a gerontology nurse practitioner in Colorado Springs, CO with 10 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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		AP126900	TEXAS	No
2	363LA2200X	Nurse Practitioner	Adult Health	AP126900	TEXAS	No
3	363LG0600X	Nurse Practitioner	Gerontology	AP126900	TEXAS	No
4	363LG0600X	Nurse Practitioner	Gerontology	C-APN.0000696-C-NP	COLORADO	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	341829502	MEDICAID	TEXAS
2	341829501	MEDICAID	TEXAS
3	9000145106	MEDICAID	COLORADO

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: 11/14/2023

NPI Synchronization or Removal

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