Melanie Nicole Fossinger, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

RN2291767 Issued in MA

Practice address

11430 N Community House Rd
Charlotte, NC 28277-1591

Phone

(704) 702-2400

NPI assigned

Aug 19, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1194191593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 INDIGO CREEK TRL",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277122564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11430 N COMMUNITY HOUSE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282771591",
            "telephone_number": "704-702-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSSINGER",
        "first_name": "MELANIE",
        "middle_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-19",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MA",
            "license": "RN2291767",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MA",
            "license": "RN2291767",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN2291767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110117744A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tamatha S. Fortune, LPCA, NCC, CCMC
• William Joseph Fortuner II, MD
• Forward Motion Enterprise LLC
• Olena Fosforova, LMBT
• Nathanael David Foss, DPT
• Alexus Rae Foster
• Amy Beth Foster, LAT, ATC
• Emmerita Foster, M.S.W., L.C.S.W.A.
• Erika N Foster, ATC
• Floyd Rudolph Foster Jr.

• Gerontology Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Gerontology Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; 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.