Individual provider Active NPI

Melody L Irby, PA-C

  • Medical Physician Assistant
  • Glen Allen, VA
National Provider Identifier
1467601278
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110002838 Issued in VA
Practice address
4212 Park Place CT
Glen Allen, VA 23060-3314
Phone
(804) 332-5950
Fax
(804) 728-1086
NPI assigned
Sep 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0110002838 VA Primary

Addresses

Primary practice location

4212 Park Place CT
Glen Allen, VA 23060-3314

Mailing address

4212 Park Place CT
Glen Allen, VA 23060-3314
Phone (804) 332-5950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20110513000733 VA Practitioner - Physician Assistant 4385820018 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virginia Center for Addiction MedicineGroup PAC ID 4789960055, 16 clinicians

Practice addresses (Care Compare)

5116 Richmond Henrico Tpke
Richmond, VA 23227-3627
Phone (804) 332-5950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110002838VAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Patient First Richmond Medical Group PLLC CurrentSince Mar 20, 2012 Accepting new patients
Patient First Richmond Medical Group PLLC CurrentSince Mar 20, 2012 Accepting new patients

Locations

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

601 Potomac Station Dr NE
Leesburg, VA 20176
Phone (703) 840-1396

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": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1467601278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4212 PARK PLACE CT",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603314",
            "telephone_number": "804-332-5950",
            "fax_number": "804-728-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 PARK PLACE CT",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603314",
            "telephone_number": "804-332-5950",
            "fax_number": "804-728-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRBY",
        "first_name": "MELODY",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-17",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110002838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

Verify at the official NPI Registry.