Individual provider Active NPI

Melissa Sheree Todd, FNP

  • Family Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1083440481
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1818039 Issued in NC
Practice address
242 Oaksburg Dr
Winston Salem, NC 27107-7709
Phone
(336) 926-2323
NPI assigned
Mar 21, 2019
Reactivated
Sep 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5011755 NC
Family Nurse Practitioner 363LF0000X 1818039 NC Primary

Addresses

Primary practice location

242 Oaksburg Dr
Winston Salem, NC 27107-7709

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (336) 718-4390

Other practice location 1

652 E Monmouth St
Winston Salem, NC 27107-3227
Phone (336) 718-4390

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
5011755NCMDNurse Practitioner
1818039NCMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: mtodd1596217@direct.novanthealth.org

NPI Registry JSON

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1083440481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "336-718-4390",
            "fax_number": "336-718-4399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 OAKSBURG DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271077709",
            "telephone_number": "336-926-2323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "652 E Monmouth St",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271073227",
            "country_code": "US",
            "telephone_number": "336-718-4390",
            "fax_number": "336-718-4399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "replacement_npi": "1083440481",
        "last_name": "TODD",
        "first_name": "MELISSA",
        "middle_name": "SHEREE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-21",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "deactivation_date": "2024-08-29",
        "reactivation_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5011755",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "1818039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.