Nicole Eden Melograna, PA-C

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

C0002638 Issued in MA

Practice address

621 Ridgely Ave
Suite 201
Annapolis, MD 21401

Phone

(410) 224-4404

Fax

(410) 224-2675

NPI assigned

May 23, 2011

Last updated

May 23, 2011By the provider in NPPES

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)

Not enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1306108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306108800000",
    "number": "1740573864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 RIDGELY AVENUE",
            "address_2": "SUITE 201",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "21401",
            "telephone_number": "410-224-4404",
            "fax_number": "410-224-2675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 RIDGELY AVE",
            "address_2": "SUITE 201",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "21401",
            "telephone_number": "410-224-4404",
            "fax_number": "410-224-2675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELOGRANA",
        "first_name": "NICOLE",
        "middle_name": "EDEN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-23",
        "last_updated": "2011-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "C0002638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barry Ross Meisenberg, M.D.
• Edward Taylor Meiser Jr., D.D.S.
• Hannah Grace Melchner
• Meghan C. Melinchak, ATC, LAT, AIB-VR/CON
• Brady Calvin Mellinger, PT, DPT, LAT, ATC
• Stephen Joseph Melvin
• Gulzeb Memon
• Katherine Mendez-Mahone
• Neil Mendhiratta, MD
• Brooke Lauren Menefee, NP

• Surgery Physician in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Surgery Physician in Maryland

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

Verify at the official NPI Registry.