Individual provider Active NPI

Melanie Kitchings Pniewski, CPNP

  • Pediatric Nurse Practitioner
  • Aiken, SC
National Provider Identifier
1407283229
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
18600 Issued in SC
Practice address
215 Town Creek Rd
Aiken, SC 29803-5843
Phone
(803) 508-7651
Fax
(803) 508-7655
NPI assigned
Oct 11, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN165910 GA
Pediatric Clinical Nurse Specialist 364SP0200X 18600 SC
Pediatric Nurse Practitioner 363LP0200X 18600 SC Primary

Addresses

Primary practice location

215 Town Creek Rd
Aiken, SC 29803-5843

Mailing address

PO Box 13955
Charleston, SC 29422-3955
Phone (803) 508-7651

Other identifiers 1

IdentifierTypeStateIssuer
NP3157MedicaidSC

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
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN165910GAMDPediatric Nurse Practitioner
18600SCMDPediatric Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Doctors LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mpniewski@tiffanypeds.gwaydirect.com
  • Direct secure messaging: mpniewski@libertydoctors.ssdirect.aprima.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1381449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1407283229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13955",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294223955",
            "telephone_number": "803-508-7651",
            "fax_number": "803-508-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 TOWN CREEK RD",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298035843",
            "telephone_number": "803-508-7651",
            "fax_number": "803-508-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PNIEWSKI",
        "first_name": "MELANIE",
        "middle_name": "KITCHINGS",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-11",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN165910",
            "primary": false
        },
        {
            "code": "364SP0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Pediatrics",
            "state": "SC",
            "license": "18600",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "18600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP3157",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.