Mellissa Willette, BSN, IBCLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

27625 Issued in SC

Practice address

2209 Sunny Valley CT
Fort Mill, SC 29707-7770

Phone

(864) 354-0786

NPI assigned

Nov 10, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor on Science - Nursing

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mellissa.willette.1@7423.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/7423/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Carolina Urgent & Family Care

  • Primary Care Clinic/Center
  • Lancaster, SC
  • NPI 1295761492

  Multi-Specialty

  Medicare reassignment NPD
• Carolina Urgent & Family Care

  • Rural Health Clinic/Center
  • Lancaster, SC
  • NPI 1043412885
  NPD

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

{
    "created_epoch": "1541808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1235607995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 SUNNY VALLEY CT",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297077770",
            "telephone_number": "864-354-0786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 SUNNY VALLEY CT",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297077770",
            "telephone_number": "864-354-0786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLETTE",
        "first_name": "MELLISSA",
        "credential": "BSN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-10",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "SC",
            "license": "L-35546",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "27625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Whitfield, CNM
• Whole Counseling LLC
• Wholistic Advantage
• Matthew Wiggins, LPCA
• Tinashia Wilkins
• William S. Burns, D.M.D, P.a.
• Dennis Demetrius Williams, MA,ATC,LAT,PES,CES
• Jennifer Paige Williams, MD
• Justice Williams, RBT
• Margaret Williams

• Nurse Practitioner in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.