MELISSA MANTOOTH LPN NPI 1235501693
Licensed Practical Nurse in Fort Rucker, AL
About MELISSA MANTOOTH
Melissa Mantooth is a provider established in Fort Rucker, Alabama and her medical specialization is licensed practical nurse. The NPI number of Melissa Mantooth is 1235501693 and was assigned on October 2015. The practitioner's primary taxonomy code is 164W00000X with license number 2066467 (AL). The provider is registered as an individual and her NPI record was last updated 6 years ago.
Melissa Mantooth is a non-participating provider of Medicare. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.
| NPI | 1235501693 |
| Provider Name | MELISSA MANTOOTH LPN |
| Provider Location Address | BUILDING 301 ANDREWS AVE. LYSTER ARMY HEALTH CLINIC FORT RUCKER, AL 36362 |
| Provider Mailing Address | BUILDING 301 ANDREWS AVE. LYSTER ARMY HEALTH CLINIC FORT RUCKER, AL 36362 |
| Gender | Female |
| NPI Entity Type | Individual |
| Is Sole Proprietor? | No |
| Is Organization Subpart? | N/A |
| Enumeration Date | 10-26-2015 |
| Last Update Date | 10-26-2015 |
Primary Taxonomy
| Taxonomy Code | 164W00000X |
| Classification | Licensed Practical Nurse |
| Type | Nursing Service Providers |
| License No. | 2066467 |
| License State | AL |
| Taxonomy Description | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
Business Address
MELISSA MANTOOTH LPN
BUILDING 301 ANDREWS AVE.
LYSTER ARMY HEALTH CLINIC
FORT RUCKER, AL
ZIP 36362
Phone: (334) 255-7930
Mailing Address
MELISSA MANTOOTH LPN
BUILDING 301 ANDREWS AVE.
LYSTER ARMY HEALTH CLINIC
FORT RUCKER, AL
ZIP 36362
Phone: (334) 255-7930
Secondary Taxonomies
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.
| No. | Taxonomy Code | Type | Classification | Specialization | License No. | State | Primary |
|---|---|---|---|---|---|---|---|
| 1 | 164W00000X | Nursing Service Providers | Licensed Practical Nurse | P324855 | MS | No | |
Taxonomy Description: an individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. | |||||||
| 2 | 164W00000X | Nursing Service Providers | Licensed Practical Nurse | LPN16824 | HI | No | |
Taxonomy Description: an individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. | |||||||
Other Providers at the same location
The following 10 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1912130337 | MS. RISHANA AMANDA DUNN EMT Individual | Emergency Medical Technician, Basic | BUILDING 301 ANDREWS AVE. LYSTER ARMY HEALTH CLINIC FORT RUCKER, AL 36362 (334) 255-7395 |
| 1740512110 | WILLIAM GABERIL FARMER EMT Individual | Emergency Medical Technician, Basic | BUILDING 301 ANDREWS AVE. LYSTER ARMY HEALTH CLINIC FORT RUCKER, AL 36362 (334) 255-7920 |
| 1366751703 | LAKEISHA YVETTE DICKINSON PSYCH TECH Individual | Specialist/Technologist, Other | BUILDING 301 ANDREWS AVE. LYSTER ARMY HEALTH CLINIC FT. RUCKER, AL 36362 (334) 255-0439 |
| 1710282512 | MELISSA GAIL CAVANAUGH RN Individual | Registered Nurse | BUILDING 301 ANDREWS AVE. LYSTER ARMY HEALTH CLINIC FT. RUCKER, AL 36362 (334) 255-7383 |
| 1922352384 | CHARLENE HALL LPN Individual | Licensed Practical Nurse | BUILDING 301 ANDREWS AVE. FORT RUCKER, AL 36362 (334) 255-7363 |
| 1417393794 | MR. DEREK JAMES ADAMS SR. NREMT Individual | Emergency Medical Technician, Basic | BUILDING 301 ANDREWS AVE. LYSTER ARMY HEALTH CLINIC FT. RUCKER, AL 36362 (931) 338-7965 |
| 1073945317 | MR. ERIC JOINER Individual | Emergency Medical Technician, Basic | BUILDING 301 ANDREWS AVE. LYSTER ARMY HEALTH CLINIC FT. RUCKER, AL 36362 (334) 255-7573 |
| 1407276652 | VALERIE KAY WOLFORD LPN Individual | Licensed Practical Nurse | BUILDING 301 ANDREWS AVE. LYSTER ARMY HEALTH CLINIC FORT RUCKER, AL 36362 (334) 255-7341 |
| 1770974701 | DAKOTA TERRELL NREMT Individual | Emergency Medical Technician, Basic | BUILDING 301 ANDREWS AVE. LYSTER ARMY HEALTH CLINIC FORT RUCKER, AL 36362 (334) 255-7185 |
| 1356871206 | SHANDY DANIELLE HOEFFER HEALTH TECHNICIAN Individual | Technician/Technologist (Optometric Technician) | BUILDING 301 ANDREWS AVE. LYSTER ARMY HEALTH CLINIC FORT RUCKER, AL 36362 |
NPI Footnotes
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.