MELVIN VICTOR ECKLES (NPI# 1003331232) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1003331232 |
Entity Type | Individual |
Full Name | MELVIN VICTOR ECKLES |
Practice Address |
1200 N Telegraph Rd Pontiac MI 48341-1032 |
Mailing Address |
1200 N Telegraph Rd Bldg 32e Pontiac MI 48341-1032 |
Practice Telephone | 2484513742 |
Mailing Telephone | 2484512656 |
Enumeration Date | 2017-08-09 |
Last Update Date | 2017-08-09 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 175T00000X | Peer Specialist | Other Service Providers |
Street Address |
1200 N TELEGRAPH RD |
City | PONTIAC |
State | MI |
Zip Code | 48341-1032 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649245010 | Christy Marie Thallman | Nurse Practitioner | 1200 N Telegraph Rd, Bldg. 32e, Pontiac, MI 48341-1032 | 2006-02-21 |
1912533266 | David Anthony Dudek | Counselor | 1200 N Telegraph Rd, Pontiac, MI 48341-1032 | 2020-03-19 |
1104477405 | Caitlin Jayne Lyons | Social Worker | 1200 N Telegraph Rd, Pontiac, MI 48341-1032 | 2019-09-27 |
1508421355 | Joseph Arthur Keith Sudau | Registered Nurse | 1200 N Telegraph Rd, Pontiac, MI 48341-1032 | 2019-05-07 |
1811462823 | Ashley Marie Snowden | Psychologist | 1200 N Telegraph Rd, Pontiac, MI 48341-1032 | 2018-10-05 |
1073099255 | Latonna Marika Caleb-hughes | Social Worker | 1200 N Telegraph Rd, Pontiac, MI 48341-1032 | 2018-07-11 |
1700379708 | Molly King | Social Worker | 1200 N Telegraph Rd, Pontiac, MI 48341-1032 | 2018-06-13 |
1962992990 | Michelle Faye Stepp | Emergency Medical Technician, Paramedic | 1200 N Telegraph Rd, Pontiac, MI 48341-1032 | 2018-05-15 |
1710480769 | Joshua Walendzik | Emergency Medical Technician, Paramedic | 1200 N Telegraph Rd, Pontiac, MI 48341-1032 | 2018-03-15 |
1811404833 | Matthew Justin Gay | Case Manager/Care Coordinator | 1200 N Telegraph Rd, Pontiac, MI 48341-1032 | 2017-12-29 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003415837 | Brittany Taylor Shandor | Registered Nurse | 32 East, 1200 Telegraph Rd, Pontiac, MI 48341 | 2020-10-22 |
1013534999 | Siddharth Chopra | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue Saint Joseph Mercy Oakland Hospit, Medical Education H-23, Pontiac, MI 48341 | 2020-06-26 |
1972120962 | Tara Elizabeth Bjorklund | Obstetrics & Gynecology | 44405 Woodward Ave - H23, St. Joseph Mercy Oakland - Gme Office, Pontiac, MI 48341 | 2020-06-25 |
1245856145 | Sarah Fatima | Student in an Organized Health Care Education/Training Program | St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue, Medical Education H-23, Pontiac, MI 48341 | 2020-06-17 |
1407471188 | Tyler Schaefer | Emergency Medical Technician, Basic | 32east 1200 N. Telegraph Rd., Pontiac, MI 48341 | 2020-06-09 |
1639793581 | Yash Kirankumar Varma | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue, Medical Education H-23, Pontiac, MI 48341 | 2020-06-05 |
1326661687 | Fnu Kavita | Student in an Organized Health Care Education/Training Program | C/o Shelly Casey, St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue Medical Education - H23, Pontiac, MI 48341 | 2020-05-21 |
1801452578 | Lolita Curry | Registered Nurse | 32 East 1200 Telegraph, Pontiac, MI 48341 | 2019-05-17 |
1619530060 | Priyadarshini Dixit | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue, St. Joseph Mercy Oakland Hospita, Pontiac, MI 48341 | 2019-04-20 |
1891358370 | Anil Gurpersaud | Student in an Organized Health Care Education/Training Program | 44405 Woodward Ave., St. Joseph Mercy Oakland, Pontiac, MI 48341 | 2019-04-19 |
Find all providers in zip 48341 |
Taxonomy Code | 175T00000X |
Grouping | Other Service Providers |
Classification | Peer Specialist |
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376156919 | Larry G West II | Peer Specialist | 1685 Baldwin Ave Ste 100, Pontiac, MI 48340-1242 | 2020-08-24 |
1093348906 | Robert Corey | Peer Specialist | 1841 N Perry St, Pontiac, MI 48340-2235 | 2020-02-19 |
1861025991 | Jordan Mark Shulman | Peer Specialist | 1841 N Perry St, Pontiac, MI 48340-2235 | 2020-02-17 |
1528579174 | Michael Lee Mcfarland | Peer Specialist | 1200 N Telegraph Rd Bldg 32, Pontiac, MI 48341-1032 | 2017-10-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063026284 | Leah Mae Sindone | Peer Specialist | 22324 Derby Rd, Woodhaven, MI 48183-3700 | 2020-09-04 |
1992314728 | Willie Earl Feggins | Peer Specialist | 370 Country Club Rd, Holland, MI 49423-8303 | 2020-07-28 |
1831711613 | John Lee Williams Jr. | Peer Specialist | 24400 Schoolcraft, Redford, MI 48239-2633 | 2020-05-14 |
1568084861 | Zannie Roy Jackson Jr. | Peer Specialist | 36801 Ann Arbor Trl, Livonia, MI 48150-3422 | 2020-05-11 |
1417578865 | Veronica R Vasquez | Peer Specialist | 500 Hancock St # 48602, Saginaw, MI 48602-4224 | 2020-04-27 |
1235768680 | Matthew Milz | Peer Specialist | 145o S Lapeer Rd, Oxford, MI 48371-4982 | 2020-04-07 |
1558996132 | Camille Jewell Jackson | Peer Specialist | 8181 N Wayne Rd Apt S2147, Westland, MI 48185-3842 | 2020-03-04 |
1073146908 | James Laroach | Peer Specialist | 913 W. Homes Suite 200, Lansing, MI 48910 | 2020-02-19 |
1578193827 | Axel Lee Gruenberg | Peer Specialist | 221790 West 9 Mile, Southfield, MI 48033 | 2020-01-24 |
1962032078 | Brianne Salchert | Peer Specialist | 1170 Michigan Rd., Port Huron, MI 48060 | 2020-01-17 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.