Individual provider Active NPI

Melissa Anne Jones Nulton, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Burke, VA
National Provider Identifier
1063646016
Registry record updated Feb 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
0202211921 Issued in VA
Practice address
8975 Home Guard Dr
Burke, VA 22015-2190
Phone
(703) 425-2030
NPI assigned
May 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 10725 SC
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 1803 AK
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 0202211921 VA Primary

Addresses

Primary practice location

8975 Home Guard Dr
Burke, VA 22015-2190

Mailing address

8975 Home Guard Dr
Burke, VA 22015-2190
Phone (703) 425-2030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
10725SCMDPharmacist
0202211921VAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
1803AKMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361491200000",
    "number": "1063646016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8975 HOME GUARD DR",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220152190",
            "telephone_number": "703-425-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8975 HOME GUARD DR",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220152190",
            "telephone_number": "703-425-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NULTON",
        "first_name": "MELISSA",
        "middle_name": "ANNE JONES",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-05",
        "last_updated": "2013-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "10725",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "AK",
            "license": "1803",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "VA",
            "license": "0202211921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.