Active NPI
Melissa Jackson, PHARMD
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Fort Worth, TX
National Provider Identifier
1790280113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 67006
- Practice address
- 1350 S Main St Ste 1600
Fort Worth, TX 76104-7663 - Phone
- (817) 702-4663
- Fax
- (817) 702-6924
- NPI assigned
- Mar 27, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 67006 | TX | |
| Infectious Diseases Pharmacist | 1835I0206X | 67006 | TX | |
| Ambulatory Care Pharmacist | 1835P2201X | 67006 | TX | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 67006 | TX | Primary |
Addresses
Primary practice location
1350 S Main St Ste 1600
Fort Worth, TX 76104-7663
Mailing address
1350 S Main St Ste 1600
Fort Worth, TX 76104-7663
Phone (817) 702-4663
Other names 1
- Melissa Nacu Weller
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
- Credentials
- Doctor of Pharmacy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684713600000",
"number": "1790280113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1350 S MAIN ST STE 1600",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761047663",
"telephone_number": "817-702-4663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 S MAIN ST STE 1600",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761047663",
"telephone_number": "817-702-4663",
"fax_number": "817-702-6924"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "MELISSA",
"name_prefix": "Ms.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-27",
"last_updated": "2023-05-22",
"certification_date": "2023-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "67006",
"primary": false
},
{
"code": "1835I0206X",
"taxonomy_group": "",
"desc": "Pharmacist, Infectious Diseases",
"state": "TX",
"license": "67006",
"primary": false
},
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "TX",
"license": "67006",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "TX",
"license": "67006",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MELISSA",
"last_name": "WELLER",
"middle_name": "NACU",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.