Melissa N. Bacchus, MD, PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

22766 Issued in WV

Legal business name

MELISSA N. BACCHUS, MD, PLLC

Practice address

4607 Maccorkle Ave SW
Medical Pavilion Suite 204
South Charleston, WV 25309-1364

Phone

(304) 767-7930

Fax

(304) 767-7935

NPI assigned

Aug 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Melissa N Bacchus, M.D.

Title

Physician

Phone

(304) 767-7930

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188345600000",
    "number": "1124212527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4607 MACCORKLE AVE SW",
            "address_2": "MEDICAL PAVILION SUITE 204",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091364",
            "telephone_number": "304-767-7930",
            "fax_number": "304-767-7935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4607 MACCORKLE AVE SW",
            "address_2": "MEDICAL PAVILION SUITE 204",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091364",
            "telephone_number": "304-767-7930",
            "fax_number": "304-767-7935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELISSA N. BACCHUS, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-08-29",
        "status": "A",
        "authorized_official_last_name": "BACCHUS",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "304-767-7930",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "22766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Skilar Faithidallas Means
• Robert Mears, PHYSICAL THERAPIST
• Medexpress Urgent Care, Inc - West Virginia
• Justin Kiel Medlin, PA-C
• Nayana R. Megha, M.D.
• Ashley Ebersole Mellert, PA-C
• Robert Meraki
• Veta Merritt
• Clara Ruby Merryman
• Jordan Messinger

• Pediatrics Physician in South Charleston, WV
• Providers in South Charleston, WV by specialty
• Pediatrics Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; 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.