Individual provider Active NPI

Melissa D Phares, APRN, FNP-C

  • Family Nurse Practitioner
  • Elkins, WV
National Provider Identifier
1477019461
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
66275 Issued in WV
Practice address
812 Gorman Ave
Elkins, WV 26241-3181
Phone
(304) 636-3300
Fax
(304) 637-3435
NPI assigned
Feb 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 66275 WV Primary

Addresses

Primary practice location

812 Gorman Ave
Elkins, WV 26241-3181

Mailing address

812 Gorman Ave
Elkins, WV 26241-3181
Phone (304) 636-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20190315001567 WV Practitioner - Nurse Practitioner 4183964893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Davis Memorial HospitalGroup PAC ID 3072418540, 77 clinicians

Practice addresses (Care Compare)

812 Gorman Ave
Elkins, WV 26241-3181
Phone (304) 636-3366

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
66275WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Davis Memorial Hospital CurrentSince Apr 1, 2019 Accepting new patients
Davis Memorial Hospital CurrentSince Apr 1, 2019 Accepting new patients

Locations

812 Gorman Ave
Elkins, WV 26241
Phone (304) 636-3300

Interoperability endpoints

  • Direct secure messaging: melissa.kisner.p1@direct.davismedicalcenter.nextgenshare.com

Organizations & group practices 2

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1477019461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 GORMAN AVE",
            "city": "ELKINS",
            "state": "WV",
            "postal_code": "262413181",
            "telephone_number": "304-636-3300",
            "fax_number": "304-637-3435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 GORMAN AVE",
            "city": "ELKINS",
            "state": "WV",
            "postal_code": "262413181",
            "telephone_number": "304-636-3300",
            "fax_number": "304-637-3435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHARES",
        "first_name": "MELISSA",
        "middle_name": "D",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-14",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "66275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkins, WV

Sources for this page

Verify at the official NPI Registry.