1609544683 NPI number — MELANI GRIEFF PT, DPT

Table of content: MELANI GRIEFF PT, DPT (NPI 1609544683)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609544683 NPI number — MELANI GRIEFF PT, DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GRIEFF
Provider First Name:
MELANI
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT, DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GRAVES
Provider Other First Name:
MELANI
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1609544683
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/02/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
215 COLUMNS WAY APT 202
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRING HILL
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37174-1469
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-613-6521
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 WINNERS CIR S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRENTWOOD
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37027-5052
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-221-9001
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/02/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  2305210271 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2251G0304X , with the licence number: 13658 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2305210271 . This is a "VA DEPT OF HEALTH PROFESSIONS- PHYSICAL THERAPIST" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 13658 . This is a "TN DEPT OF HEALTH- PHYSICAL THERAPIST" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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