Individual provider Active NPI

Melissa Lee Mathias, FNP-BC

  • Family Nurse Practitioner
  • Petersburg, WV
National Provider Identifier
1801146071
Registry record updated May 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71048 Issued in WV
Practice address
10 Mulligan Drive
Petersburg, WV 26847-1511
Phone
(304) 257-2451
NPI assigned
Sep 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2015

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 71048 WV Primary

Addresses

Primary practice location

10 Mulligan Drive
Petersburg, WV 26847-1511

Mailing address

3647 US Highway 220 N
Moorefield, WV 26836-8643
Phone (304) 538-3131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20191024002974 WV Practitioner - Nurse Practitioner 2365755675 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grant Memorial Hospital IncGroup PAC ID 4183082712, 38 clinicians

Practice addresses (Care Compare)

117 Hospital Dr
Petersburg, WV 26847-9566
Phone (304) 257-1026

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71048WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grant Memorial Hospital Current Accepting new patients
Grant Memorial Hospital Inc CurrentSince Jul 1, 2023 Accepting new patients
Grant Memorial Hospital CurrentSince Sep 1, 2019 Accepting new patients
Grant Memorial Hospital CurrentSince Sep 1, 2019 Accepting new patients
Grant Memorial Hospital Inc CurrentSince Jul 1, 2023 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

10 Mulligan Dr
Petersburg, WV 26847
Phone (304) 257-2451

117 Hospital Dr
Petersburg, WV 26847
Phone 30497450009312

Interoperability endpoints

  • Direct secure messaging: mmathia2@yourcarecommunity.org
  • Direct secure messaging: mmathias@hawsehealth.direct.emds.com

Organizations & group practices 6

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430697600000",
    "number": "1801146071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3647 US HIGHWAY 220 N",
            "city": "MOOREFIELD",
            "state": "WV",
            "postal_code": "268368643",
            "telephone_number": "304-538-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MULLIGAN DRIVE",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268471511",
            "telephone_number": "304-257-2451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIAS",
        "first_name": "MELISSA",
        "middle_name": "LEE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-14",
        "last_updated": "2015-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "71048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, WV

Sources for this page

Verify at the official NPI Registry.