Individual provider Active NPI

Melissa Buckner Wayne, NP-C

  • Nurse Practitioner
  • Shallotte, NC
National Provider Identifier
1528414612
Registry record updated Mar 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5008560 Issued in NC
Practice address
5160 Ocean Hwy W
Shallotte, NC 28470-4012
Phone
(910) 332-3800
Fax
(910) 332-3833
NPI assigned
May 9, 2016
Last updated
Mar 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5008560 NC Primary
Registered Nurse 163W00000X 238638 NC

Addresses

Primary practice location

5160 Ocean Hwy W
Shallotte, NC 28470-4012

Mailing address

2716 Ashton Dr
Wilmington, NC 28412-2489
Phone (910) 332-3800

Other names 1

  • Melissa Ashley Buckner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20160627001676 NC Practitioner - Nurse Practitioner 4587955299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergeortho PAGroup PAC ID 0749188894, 726 clinicians

Practice addresses (Care Compare)

120 William Penn PLZ
Durham, NC 27704-2150
Phone (919) 220-5255

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.07 of 100Reported as group
Quality
85.94
Promoting interoperability
100
Improvement activities
40
Cost
77.63

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
238638NCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Emergeortho PA CurrentSince Jun 1, 2016 Accepting new patients
Emergeortho PA CurrentSince Jun 1, 2016 Accepting new patients

Locations

120 William Penn Plz
Durham, NC 27704
Phone (919) 281-1836

799 Doctors Ct
Roxboro, NC 27573
Phone (336) 599-4079

5160 Ocean Hwy W
Shallotte, NC 28470
Phone (910) 332-3828

2716 Ashton Dr
Wilmington, NC 28412
Phone (910) 332-1534

Interoperability endpoints

  • Direct secure messaging: melissa.buckner.1@847.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553126400000",
    "number": "1528414612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2716 ASHTON DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122489",
            "telephone_number": "910-332-3800",
            "fax_number": "910-251-0421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5160 OCEAN HWY W",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284704012",
            "telephone_number": "910-332-3800",
            "fax_number": "910-332-3833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAYNE",
        "first_name": "MELISSA",
        "middle_name": "BUCKNER",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-09",
        "last_updated": "2019-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5008560",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "238638",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "BUCKNER",
            "middle_name": "ASHLEY",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Shallotte, NC

Sources for this page

Verify at the official NPI Registry.