Active NPI
Melody Rose Heiskell, M.D.
- Pediatrics Physician
- Fairfax, VA
National Provider Identifier
1386821536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0101245374
- Practice address
- 8316 Arlington Blvd Ste 300
Fairfax, VA 22031-5216 - Phone
- (703) 573-2432
- NPI assigned
- Jan 29, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 002165 | GA | |
| Pediatrics Physician | 208000000X | 0101245374 | VA | Primary |
Addresses
Primary practice location
8316 Arlington Blvd Ste 300
Fairfax, VA 22031-5216
Mailing address
2005 Beacon PL
Reston, VA 20191-4843
Phone (404) 290-1244
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0101245374 | Other | VA | VIRGINIA LICENSE |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101245374 | VA | MD | Pediatrics Physician |
| 002165 | GA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virginia Pediatric Group, LTD | Single Specialty | Past | Accepting new patients |
| Virginia Pediatric Group | Single Specialty | Past | Accepting new patients |
| Lima Memorial Joint Operating Company | Single Specialty | Past | Accepting new patients |
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.
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645142400000",
"number": "1386821536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2005 BEACON PL",
"city": "RESTON",
"state": "VA",
"postal_code": "201914843",
"telephone_number": "404-290-1244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8316 ARLINGTON BLVD STE 300",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220315216",
"telephone_number": "703-573-2432"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEISKELL",
"first_name": "MELODY",
"middle_name": "ROSE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-29",
"last_updated": "2022-02-18",
"certification_date": "2022-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "002165",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"state": "VA",
"license": "0101245374",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIRGINIA LICENSE",
"identifier": "0101245374",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.