Alexandra Elizabeth Malissen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-12476 Issued in NC

Practice address

1601 Brenner Ave
Salisbury, NC 28144-2515

Phone

(704) 638-9000

NPI assigned

Jul 1, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1659004240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7612 ANNBICK LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282699100",
            "telephone_number": "910-364-6397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 BRENNER AVE",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442515",
            "telephone_number": "704-638-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALISSEN",
        "first_name": "ALEXANDRA",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-01",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12476",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Magryta, RD
• Diana Mah, O.D.
• Caitlyn Ann Mahoney, LCSWA
• Lubabatu Inuwa Maimai
• Main Street Physical Therapy Inc
• Eric John Mallico, MD
• James A Mallinson Jr., MA
• Sean I Malone, M.D.
• Sean Robert Maloney, M.D.
• Gary Lee Mancil, O.D.

• Physician Assistant in Salisbury, NC
• Providers in Salisbury, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.