Active NPI
Melissa Marie Dugan, PA
- Physician Assistant
- Crestview, FL
National Provider Identifier
1194385146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9111994
- Practice address
- 150 E Redstone Ave Ste B
Crestview, FL 32539-5343 - Phone
- (850) 983-7778
- NPI assigned
- Jun 20, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9111994 | FL | Primary |
Addresses
Primary practice location
150 E Redstone Ave Ste B
Crestview, FL 32539-5343
Mailing address
1855 Princeton Dr
Clearwater, FL 33765-1420
Phone (727) 488-4328
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9111994 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560988800000",
"number": "1194385146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1855 PRINCETON DR",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337651420",
"telephone_number": "727-488-4328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 E REDSTONE AVE STE B",
"city": "CRESTVIEW",
"state": "FL",
"postal_code": "325395343",
"telephone_number": "850-983-7778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUGAN",
"first_name": "MELISSA",
"middle_name": "MARIE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-20",
"last_updated": "2019-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "9111994",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crestview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.