Melissa Jo Mavis, ARNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

4027273 Issued in KY

Practice address

617 23Rd St Ste 400
Ashland, KY 41101-2880

Phone

(606) 408-5864

Fax

(606) 408-6499

NPI assigned

Oct 14, 2024

Last updated

Mar 31, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Kings Daughters Medical Specialties Inc

  dba Kings Daughters Medical Specialities Physical Medicine and Rehab

  • Physical Medicine & Rehabilitation Physician
  • Prestonsburg, KY
  • NPI 1710215736
  Medicare reassignment

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

{
    "created_epoch": "1728864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1275353336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 LEXINGTON AVE",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012843",
            "telephone_number": "606-408-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 23RD ST STE 400",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012880",
            "telephone_number": "606-408-5864",
            "fax_number": "606-408-6499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAVIS",
        "first_name": "MELISSA",
        "middle_name": "JO",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-14",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "4027273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul S. Matharoo, MD
• Mathew.P.Samuel,MD PSC
• Khan Matin, MD
• Matthew J Pierzala DO PSC
• Maurice J. Oakley,M.D.,P.S.C.
• Amanda Rose Maxim, M.S., CCC-SLP
• Crystal Mayes
• Angela Maynard
• Breanna Maynard
• David Maynard, CSW

• Acute Care Nurse Practitioner in Ashland, KY
• Providers in Ashland, KY by specialty
• Acute Care Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.