Active NPI
Marrissa C Pelletier, MD
- Pediatrics Physician
- Franklin, NC
National Provider Identifier
1083816912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2014-00372
- Practice address
- 427 Harrison Ave
Franklin, NC 28734-2580 - Phone
- (828) 524-7337
- Fax
- (828) 369-1340
- NPI assigned
- Jun 4, 2007
- Last updated
- Nov 12, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 243167 | NY | |
| Pediatrics Physician | 208000000X | 2014-00372 | NC | Primary |
Addresses
Primary practice location
427 Harrison Ave
Franklin, NC 28734-2580
Mailing address
PO Box 647
Hope Mills, NC 28348-0647
Phone (910) 483-7337
Other identifiers 20
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083816912 | Other | NC | HUMANA |
| 1083816912 | Medicaid | NC | |
| 9208288 | Other | NC | CIGNA GREATWEST |
| 984960 | Other | GA | WELLCARE |
| 003145877A | Other | GA | PEACHCARE 4 KIDS |
| 4302375 | Other | NC | COVENTRY NATIONAL - COVENTRY PPO |
| FH1101660 | Other | NC | FIRST CAROLINA CARE |
| 1083816912 | Other | NC | HEALTHSMART |
| 02900278 | Medicaid | NY | |
| 12669052 | Other | NC | PHCS-MULTIPLAN |
| 1461884 | Other | NC | WELLPATH |
| 186BW | Other | NC | BCBS OF NC |
| 276479 | Other | NC | MEDCOST, LLC |
| 2379703 | Other | AMERIGROUP | |
| 2889619 | Other | NC | UNITED HEALTHCARE |
| 003145877A | Medicaid | GA | |
| 1083816912 | Other | NC | HEALTHNET FEDERAL SERVICES |
| 1083816912 | Other | NC | DOCTORS DIRECT |
| 1461884 | Other | NC | COVENTRY OF THE CAROLINAS |
| 9102458 | Other | NC | AETNA |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2014-00372 | NC | MD | Pediatrics Physician |
| 243167 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kidzcare Pediatrics, PC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatrics Physician
- Hope Mills, NC
- NPI 1679529051
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447286400000",
"number": "1083816912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 647",
"city": "HOPE MILLS",
"state": "NC",
"postal_code": "283480647",
"telephone_number": "910-483-7337",
"fax_number": "910-483-0648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "427 HARRISON AVE",
"city": "FRANKLIN",
"state": "NC",
"postal_code": "287342580",
"telephone_number": "828-524-7337",
"fax_number": "828-369-1340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELLETIER",
"first_name": "MARRISSA",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-04",
"last_updated": "2015-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "243167",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "2014-00372",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "1083816912",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1083816912",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA GREATWEST",
"identifier": "9208288",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "984960",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PEACHCARE 4 KIDS",
"identifier": "003145877A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY NATIONAL - COVENTRY PPO",
"identifier": "4302375",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST CAROLINA CARE",
"identifier": "FH1101660",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHSMART",
"identifier": "1083816912",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02900278",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS-MULTIPLAN",
"identifier": "12669052",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLPATH",
"identifier": "1461884",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF NC",
"identifier": "186BW",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST, LLC",
"identifier": "276479",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "2379703",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "2889619",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003145877A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET FEDERAL SERVICES",
"identifier": "1083816912",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DOCTORS DIRECT",
"identifier": "1083816912",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY OF THE CAROLINAS",
"identifier": "1461884",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "9102458",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Franklin, NC
- Pamela a. Baker LPC (Pamela A. Baker LPC & Associates)
- Jane Park, DMD
- Matthew Michael Parker, DDS
- Stacey Pavlick, PHARM D
- Pediatric Associates of Franklin, P.a.
- Sarah Lauren Perkins, PMHNP-BC
- Randall C Phillips, PT
- Play on Words Therapy Connections of NC LLC (ElemenTree Therapy Associates)
- Mary Catherine Polanski, NP
- Stanley Joseph Polanski, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.