Melissa Courtney King, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

47601 Grand River Ave Ste C202
Novi, MI 48374-1204

Phone

(248) 465-5955

Fax

(248) 465-4864

NPI assigned

Jan 14, 2018

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

Other names 1

• Melissa Courtney Gasiorek Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: mking1134743@direct.hfhs.org

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

{
    "created_epoch": "1515888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1316455215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR STE 705",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756215",
            "telephone_number": "248-465-5955",
            "fax_number": "248-465-4864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47601 GRAND RIVER AVE STE C202",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741204",
            "telephone_number": "248-465-5955",
            "fax_number": "248-465-4864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22250 Providence Dr Ste 705",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480756215",
            "country_code": "US",
            "telephone_number": "248-552-9858",
            "fax_number": "248-552-9510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "39555 W 10 Mile Rd Ste 301",
            "address_purpose": "LOCATION",
            "city": "Novi",
            "state": "MI",
            "postal_code": "483752950",
            "country_code": "US",
            "telephone_number": "248-943-9461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "MELISSA",
        "middle_name": "COURTNEY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-14",
        "last_updated": "2022-07-25",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "GASIOREK",
            "middle_name": "COURTNEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• April King
• Chelsea N King
• Jacob King
• Jashareh King
• Jeffrey Peter King
• Michelle King
• Ronisha Denise King
• Sharon Lee King
• Shelby King, A.A.S., A.A., A.G.S.
• Wendy Dyanne King

• Medical Physician Assistant in Novi, MI
• Providers in Novi, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.