Melissa J McCulley O D P C

Primary specialty

OptometristTaxonomy code 152W00000X

License

ND597 Issued in ND

Legal business name

MELISSA J MCCULLEY O D P C

Doing business as

McCulley Optix Gallery

Practice address

567 32ND Ave E
West Fargo, ND 58078-8480

Phone

(701) 373-2020

Fax

(701) 373-0021

NPI assigned

Mar 22, 2007

Last updated

Feb 9, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Melissa J McCulley, O.D.NPI 1912023714

Title

President

Phone

(701) 373-2020

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• McCulley Optix Gallery Doing business as

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Melissa J McCulley, O.D.

  • Optometrist
  • Fargo, ND
  • NPI 1912023714
  Medicare reassignment NPD Authorized official
• Tracie Malsom, OD

  • Optometrist
  • Fargo, ND
  • NPI 1720038441
  Medicare reassignment

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675900800000",
    "number": "1497871214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "567 32ND AVE E",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580788480",
            "telephone_number": "701-373-2020",
            "fax_number": "701-373-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 32ND AVE E",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580788480",
            "telephone_number": "701-373-2020",
            "fax_number": "701-373-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELISSA J MCCULLEY O D P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-02",
        "status": "A",
        "authorized_official_last_name": "MCCULLEY",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-373-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "ND",
            "license": "ND597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP NUMBER",
            "identifier": "06711001",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "88G74MC",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McCulley Optix Gallery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "McCulley Optix Gallery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cierra Mecham, RD
• Ndayishimiye Medi
• Sarah D Meinhardt, OTR
• Crystal Meis
• Anna Lea Meland, CFY-SLP
• Sarah Melton
• Carrie Menke, OTR/L
• John Mercer, SMT
• Marit Mesna, MA-CCC/SLP
• Brooke Marie Messer, O.D.

• Optometrist in West Fargo, ND
• Providers in West Fargo, ND by specialty
• Optometrist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.