Melissa Rena Kijewski, D.O.
Individual provider Active NPI Family Medicine Physician · South Charleston, WV
NPI 1124477138 · NPPES record last updated Jan 31, 2020
Key facts
- NPI
- 1124477138
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 3320 (WV)
- Practice address
- 1563 Sand Plant Rd
South Charleston, WV 25309-6120 - Phone
- (304) 756-1500
- Fax
- (304) 756-1548
- NPI assigned
- Jun 9, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 28
Hospital & facility affiliations 16
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- West Virginia School of Osteopathic Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lincoln County Primary Care Center Inc
Practice addresses (Care Compare)
1563 Sand Plant Rd
South Charleston, WV 25309-6120
Phone (304) 756-1500
26 Trinity LN
Oceana, WV 24870-2600
Phone (304) 682-6246
35767 Pond Fork Rd
Wharton, WV 25208
Phone (304) 247-6202
37456 Coal River Rd
Whitesville, WV 25209-9077
Phone (304) 854-1321
471 Main St
Madison, WV 25130-1223
Phone (304) 369-5170
Hospital & facility affiliations
- Boone Memorial Homecare
- Centerwell Home Health
- Adoration Home Health
- Charleston Area Medical Center
- Thomas Memorial Hospital
- Boone Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190917001686 | WV | Practitioner - Family Practice | 5092000695 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
Locations
3955 Parklawn Ave
Ste 120
Minneapolis, MN 55435
Phone (952) 278-7000
267 Midway Rd
Alum Creek, WV 25003
Phone (304) 756-1007
5322 McClellan Hwy
Branchland, WV 25506
Phone (304) 824-5707
40 Shae Ave
Chapmanville, WV 25508
Phone (304) 855-2211
506 Crawley Creek Rd
Chapmanville, WV 25508
Phone (304) 855-0245
8130 Court Ave
Hamlin, WV 25523
Phone 30482458061235
7400 Lynn Ave
Hamlin, WV 25523
81 Lincoln Panther Way
Hamlin, WV 25523
Phone (304) 824-6090
10 Marland Ave
Hamlin, WV 25523
Phone (304) 824-3033
1 Wildcat Way
Logan, WV 25601
Phone (304) 688-9949
122 Nick Savas Dr
Logan, WV 25601
Phone (304) 752-8081
471 Main St
Madison, WV 25130
Phone (304) 369-5170
600 E McDonald Ave
Man, WV 25635
Phone (304) 583-6541
650 E McDonald Ave
Man, WV 25635
Phone (304) 583-8585
26 Trinity Ln
Oceana, WV 24870
Phone (304) 369-1123
10008 Coal River Rd
Seth, WV 25181
Phone (304) 837-3399
1563 Sand Plant Rd
South Charleston, WV 25309
Phone (304) 756-1500
37456 Coal River Rd
Whitesville, WV 25209
Phone (304) 854-1321
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/1846cf9e-8006-4277-b72f-3cbbe8a8f5ca/
- melissa.kijewski.1@6401.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 3320 | WV | Yes |
Addresses
Primary practice location
1563 Sand Plant Rd
South Charleston, WV 25309-6120
Mailing address
3200 Maccorkle Ave. SE, Camc Family Medicine Center
Robert C. Byrd Clinical Teaching Center
Charleston, WV 25304
Phone (304) 388-4600
Other practice location 1
7400 Lynn Ave
Hamlin, WV 25523-1138
Phone (304) 824-5806 ext. 1235
NPI Registry JSON
{
"created_epoch": "1465430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580428800000",
"number": "1124477138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 MACCORKLE AVE. SE, CAMC FAMILY MEDICINE CENTER",
"address_2": "ROBERT C. BYRD CLINICAL TEACHING CENTER",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "25304",
"telephone_number": "304-388-4600",
"fax_number": "304-388-4621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1563 SAND PLANT RD",
"city": "SOUTH CHARLESTON",
"state": "WV",
"postal_code": "253096120",
"telephone_number": "304-756-1500",
"fax_number": "304-756-1548"
}
],
"practiceLocations": [
{
"address_1": "7400 Lynn Ave",
"address_purpose": "LOCATION",
"city": "Hamlin",
"state": "WV",
"postal_code": "255231138",
"country_code": "US",
"telephone_number": "304-824-5806 x1235",
"fax_number": "304-824-5804",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIJEWSKI",
"first_name": "MELISSA",
"middle_name": "RENA",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-09",
"last_updated": "2020-01-31",
"certification_date": "2020-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WV",
"license": "3320",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Charleston, WV
- Kalee Kick
- Gerezgiher Kidanu
- Mikayla Kidd
- Shelby Kidd
- Clairee Kiewra
- Caitlin Kinder
- Charles King
- Faith King
- Kennedy A King
- Robin King
All providers in South Charleston, WV · Family Medicine Physician in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2020. 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.