Individual provider Active NPI

Melissa Lynn Pickens, APRN-CNP

  • Family Nurse Practitioner
  • Charleston, WV
National Provider Identifier
1508435025
Registry record updated Jun 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
105538 Issued in WV
Practice address
3200 Maccorkle Ave SE
Charleston, WV 25304-1227
Phone
(304) 388-5460
NPI assigned
Jun 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2021

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 105538 WV Primary

Addresses

Primary practice location

3200 Maccorkle Ave SE
Charleston, WV 25304-1227

Mailing address

330 Wiblin FRK
Gay, WV 25244-9672
Phone (304) 531-2543

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Charleston Direct

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
I20211229001781 WV Practitioner - Nurse Practitioner 7517358567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-7823

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
105538WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center Inc CurrentSince Sep 21, 2021 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Sep 21, 2021 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

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": "1624060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624060800000",
    "number": "1508435025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 WIBLIN FRK",
            "city": "GAY",
            "state": "WV",
            "postal_code": "252449672",
            "telephone_number": "304-531-2543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041227",
            "telephone_number": "304-388-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKENS",
        "first_name": "MELISSA",
        "middle_name": "LYNN",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-19",
        "last_updated": "2021-06-19",
        "certification_date": "2021-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "105538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Charleston",
            "affiliation": "N",
            "endpointDescription": "hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3200 MacCorkle Ave SE",
            "city": "Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253041227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.