Individual provider Active NPI

Melissa Wilson

  • Nurse's Aide
  • Goose Creek, SC
National Provider Identifier
1639882871
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
Practice address
128 Spindle Way
Goose Creek, SC 29445-3633
Phone
(530) 965-6736
NPI assigned
Jan 3, 2023
Last updated
Mar 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's AideGroup: 193400000X SINGLE SPECIALTY GROUP 376K00000X SC Primary

Addresses

Primary practice location

128 Spindle Way
Goose Creek, SC 29445-3633

Mailing address

128 Spindle Way
Goose Creek, SC 29445-3633
Phone (530) 965-6736

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

NPI Registry JSON

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

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1639882871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 SPINDLE WAY",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294453633",
            "telephone_number": "530-965-6736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 SPINDLE WAY",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294453633",
            "telephone_number": "530-965-6736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MELISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-03",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse's Aide",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goose Creek, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.