Individual provider Active NPI

Melissa Whetzel, NP

  • Nurse Practitioner
  • Myrtle Beach, SC
National Provider Identifier
1306321310
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5011279 Issued in NC
Practice address
376 Mikita Dr
Myrtle Beach, SC 29575-5514
Phone
(336) 266-3041
NPI assigned
Sep 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 184593 NC
Adult Health Nurse Practitioner 363LA2200X 5011279 NC
Gerontology Nurse Practitioner 363LG0600X 5011279 NC
Primary Care Nurse Practitioner 363LP2300X 5011279 NC
Nurse Practitioner 363L00000X 5011279 NC Primary

Addresses

Primary practice location

376 Mikita Dr
Myrtle Beach, SC 29575-5514

Mailing address

376 Mikita Dr
Myrtle Beach, SC 29575-5514
Phone (336) 266-3041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190205002192 NC Practitioner - Nurse Practitioner 3779821418 Reassigns benefits to 1 organization
Practice locations: Mebane, NC
I20241024002764 SC Practitioner - Nurse Practitioner 3779821418 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.24 of 100Reported as group
Quality
86.38
Improvement activities
40
Cost
73.95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5011279NCMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Aug 30, 2024 Accepting new patients
Supportive Care of South Carolina LLC Nurse Practitioner CurrentSince Aug 1, 2024 Accepting new patients
Bella Vita Wellness LLC Gerontology Current Accepting new patients

Locations

555 Fayetteville St
Raleigh, NC 27601
Phone (682) 268-1011

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

2 Office Park Ct
Ste 103
Columbia, SC 29223
Phone (256) 497-0032

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1306321310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "376 MIKITA DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295755514",
            "telephone_number": "336-266-3041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "376 MIKITA DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295755514",
            "telephone_number": "336-266-3041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHETZEL",
        "first_name": "MELISSA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-26",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "184593",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5011279",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "5011279",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "5011279",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5011279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.