Individual provider Active NPI

Melissa Fricks

  • Speech-Language Pathologist
  • Charlotte, NC
National Provider Identifier
1669996690
Registry record updated Aug 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
11855 Issued in NC
Practice address
2301 Crownpoint Executive Dr Ste E
Charlotte, NC 28227-6725
Phone
(704) 708-8314
NPI assigned
Aug 1, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 11855 NC Primary

Addresses

Primary practice location

2301 Crownpoint Executive Dr Ste E
Charlotte, NC 28227-6725

Mailing address

2301 Crownpoint Executive Dr Ste E
Charlotte, NC 28227-6725

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

State licenses

LicenseStateTypeSpecialty
11855NCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501545600000",
    "number": "1669996690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 CROWNPOINT EXECUTIVE DR STE E",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282276725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 CROWNPOINT EXECUTIVE DR STE E",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282276725",
            "telephone_number": "704-708-8314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRICKS",
        "first_name": "MELISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-01",
        "last_updated": "2017-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "11855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2017; 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.