{"npi":"1053597955","type":"NPI-1","status":"active","name":{"display":"Dr. Mark Mcmellen M.D.","other":[],"first":"MARK","last":"MCMELLEN","middle":"EDWARD","credential":"M.D."},"specialty":{"primary_taxonomy":"208600000X","primary_taxonomy_description":"Surgery","slug":"surgery","schema_org_specialty":"Surgical","all":[{"code":"2086S0102X","description":"Surgical Critical Care Physician","primary":false,"state":"MO","license":"2009012459"},{"code":"208600000X","description":"Surgery","primary":true,"state":"MO","license":"2009012459"}]},"addresses":[{"purpose":"LOCATION","street_1":"11600 W SECOND PL","city":"LAKEWOOD","state":"CO","postal_code":"80228","country_code":"US","street_2":"TRAUMA DEPT.","phone":"3142516440","fax":"3142514456"},{"purpose":"MAILING","street_1":"11600 W SECOND PL","city":"LAKEWOOD","state":"CO","postal_code":"80228","country_code":"US","street_2":"TRAUMA DEPT.","phone":"3142516440","fax":"3142514456"}],"license":{"state":"MO","number":"2009012459"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"1053597955","state":"MO","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20160714001802","type_code":"14-02","type_desc":"PRACTITIONER - GENERAL SURGERY","state":"MO","pac_id":"2769784214"},{"enrlmt_id":"I20200629002219","type_code":"14-02","type_desc":"PRACTITIONER - GENERAL SURGERY","state":"CO","pac_id":"2769784214"}]},"enumeration_date":"2008-01-10","last_updated":"2022-11-30","_meta":{"source":"NPPES","snapshot_date":"2022-11-30","doc_url":"https://findmynpi.com/api"}}