Melissa Anne McCrary, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110002136 Issued in VA

Practice address

516 Innovation Dr Ste 102
Chesapeake, VA 23320-3866

Phone

(513) 834-7063

NPI assigned

Jun 14, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tidewater Physicians Multispecialty Group PC

  • Family Medicine Physician
  • Newport News, VA
  • NPI 1902848294
  NPD (past)

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1679517502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 ELSINORE PL STE 200",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452021457",
            "telephone_number": "513-834-7063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 INNOVATION DR STE 102",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203866",
            "telephone_number": "513-834-7063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Volvo Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233203341",
            "country_code": "US",
            "telephone_number": "757-389-5370",
            "fax_number": "757-389-5381",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCRARY",
        "first_name": "MELISSA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roy McCormes Jr.
• Jenna M McCormick, LCSW
• Chelsea Nicole McCorvey
• Kenia McCoy
• Tinika McCoy, MSN,RN
• Robert D McCray, MD
• Eriq McCry, MS, QMHP
• Phoebe McCutchan, PHD
• Amanda Leigh McDaniel
• Candice McDaniel

• Physician Assistant in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; 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.