Melissa Marie Hale, PA-C
Individual provider Active NPI Physician Assistant · London, KY
NPI 1063640985 · NPPES record last updated May 12, 2025
Key facts
- NPI
- 1063640985
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA1567 (KY)
- Practice address
- 300 Carrera Dr
London, KY 40741-6303 - Phone
- (606) 657-2079
- Fax
- (818) 337-3798
- NPI assigned
- Jun 30, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- University of Kentucky College of Medicine, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Encore Wound Care - Kentucky, LLC
Practice addresses (Care Compare)
2277 Thunderstick Dr
Suite 300
Lexington, KY 40505-4877
Phone (502) 552-3879
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130905000942 | KY | Practitioner - Physician Assistant | 9133362429 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA1567 | KY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Health Medical Group Inc | Physician Assistant | Current |
Accepting new patients |
| Baptist Health Medical Group Inc | Current |
Accepting new patients | |
| Encore Wound Care - Kentucky, LLC | Physician Assistant | Current |
Accepting new patients |
Locations
446 W Cumberland Gap Pkwy
Corbin, KY 40701
Phone (606) 330-4200
1 Trillium Way
Ste 301
Corbin, KY 40701
Phone (606) 526-7363
1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521
4071 Tates Creek Centre Dr
Ste 202
Lexington, KY 40517
Phone (859) 260-4390
2277 Thunderstick Dr
Ste 300
Lexington, KY 40505
Phone (502) 552-3879
731 Bay Ave
Somers Point, NJ 08244
Phone (609) 653-0232
Interoperability endpoints
- mhale7046@bhkydirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA1567 | KY | Yes |
Addresses
Primary practice location
300 Carrera Dr
London, KY 40741-6303
Mailing address
87 Wildcat LN
Corbin, KY 40701-8950
Phone (606) 261-5344
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01439783 | Other | KY | RR MEDICARE |
| PA1567 | Other | KY | MEDICAL LICENSE |
| 7100285080 | Medicaid | KY |
Other providers in London, KY
- Deborah D. Hacker
- Jazlyn Hacker
- Matthew Thomas Hacker
- Rachel Fawbush Hacker
- Alisha Hail
- Linda Fay Hall
- Tara Hall
- Eleanor Holston Ham
- Cheyenne Mariah Hamblin
- Heather Marie Hammack
All providers in London, KY · Physician Assistant in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 12, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.