Individual provider Active NPI

Melisa Green Wiese, APRN, NP-C

  • Family Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1760929616
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20615 Issued in SC
Practice address
905 Verdae Blvd Ste 202
Greenville, SC 29607-4098
Phone
(864) 676-1072
Fax
(864) 522-2105
NPI assigned
Jan 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 20615 SC Primary

Addresses

Primary practice location

905 Verdae Blvd Ste 202
Greenville, SC 29607-4098

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other identifiers 1

IdentifierTypeStateIssuer
NP4342MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mwiese163735@direct.ghs.myhfn.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170322000004 SC Practitioner - Nurse Practitioner 1052696614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Medical University of South Carolina College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

2104 Woodruff Rd
Greenville, SC 29607-5941
Phone (864) 676-1072

Hospital & facility affiliations

  • Prisma Health Hillcrest Hospital Hospital, Simpsonville, SC, CCN 420037
  • Prisma Health Patewood Hospital Hospital, Greenville, SC, CCN 420102
  • Prisma Health Greer Memorial Hospital Hospital, Spartanburg, SC, CCN 420033
  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
20615SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Feb 27, 2017 Accepting new patients
Prisma Health University Medical Group Current Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

2104 Woodruff Rd
Greenville, SC 29607
Phone (864) 676-1072

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

905 Verdae Blvd
Ste 203
Greenville, SC 29607
Phone (864) 522-2180

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

905 Verdae Blvd
Ste 202
Greenville, SC 29607
Phone (864) 522-2100

Interoperability endpoints

  • Direct secure messaging: mwiese163735@direct.ghs.myhfn.org

Organizations & group practices 2

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.

Hospital & facility affiliations 52

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1760929616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 VERDAE BLVD STE 202",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296074098",
            "telephone_number": "864-676-1072",
            "fax_number": "864-522-2105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESE",
        "first_name": "MELISA",
        "middle_name": "GREEN",
        "credential": "APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-30",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "20615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP4342",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwiese163735@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mwiese163735@direct.ghs.myhfn.org",
            "address_1": "905 Verdae Blvd Ste 202",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296074098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.