Active NPI
Melinda C Childress, PHARMD, MBA
- Pharmacist
- Statesville, NC
National Provider Identifier
1609830025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17650
- Practice address
- 3478 E Broad St
Statesville, NC 28625-4523 - Phone
- (704) 878-6681
- NPI assigned
- Apr 13, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 17650 | NC | Primary |
Addresses
Primary practice location
3478 E Broad St
Statesville, NC 28625-4523
Mailing address
3478 E Broad St
Statesville, NC 28625-4523
Phone (704) 878-6681
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Business Administration, Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17650 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322438400000",
"number": "1609830025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3478 E BROAD ST",
"city": "STATESVILLE",
"state": "NC",
"postal_code": "286254523",
"telephone_number": "704-878-6681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3478 E BROAD ST",
"city": "STATESVILLE",
"state": "NC",
"postal_code": "286254523",
"telephone_number": "704-878-6681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHILDRESS",
"first_name": "MELINDA",
"middle_name": "C",
"name_prefix": "Mrs.",
"credential": "PHARMD, MBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-13",
"last_updated": "2011-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "17650",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Statesville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.