Active NPI
Melodye Elliott Visser, MD
- Family Medicine Physician
- Carolina Beach, NC
National Provider Identifier
1245316082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0031921
- Practice address
- 1300 Bridge Barrier Rd Ste 2
Carolina Beach, NC 28428-3939 - Phone
- (910) 341-3300
- Fax
- (910) 251-2067
- NPI assigned
- Oct 27, 2006
- Last updated
- Oct 2, 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0031921 | NC | Primary |
Addresses
Primary practice location
1300 Bridge Barrier Rd Ste 2
Carolina Beach, NC 28428-3939
Mailing address
1202 Medical Center Dr
Wilmington, NC 28401-7307
Phone (910) 341-3300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7985079 | Medicaid | NC | |
| 890262 | Medicaid | NC |
Other names 1
- Melodye Elliott
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0031921 | NC | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wilmington Family Physicians PA | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Wilmington, NC
- NPI 1639488190
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569974400000",
"number": "1245316082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1202 MEDICAL CENTER DR",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284017307",
"telephone_number": "910-341-3300",
"fax_number": "910-251-2067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 BRIDGE BARRIER RD STE 2",
"city": "CAROLINA BEACH",
"state": "NC",
"postal_code": "284283939",
"telephone_number": "910-341-3300",
"fax_number": "910-251-2067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VISSER",
"first_name": "MELODYE",
"middle_name": "ELLIOTT",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-27",
"last_updated": "2019-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "0031921",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7985079",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "890262",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MELODYE",
"last_name": "ELLIOTT",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Carolina Beach, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.