Individual provider Active NPI

Melissa Dickerson Maccia, PHARMD

  • Pharmacist
  • Greensboro, NC
National Provider Identifier
1811298128
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
17540 Issued in AL
Practice address
1126 N Church St Ste 300
Greensboro, NC 27401-1037
Phone
(336) 938-0717
Fax
(336) 938-0757
NPI assigned
Nov 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 17540 AL Primary

Addresses

Primary practice location

1126 N Church St Ste 300
Greensboro, NC 27401-1037

Mailing address

1126 N Church St Ste 300
Greensboro, NC 27401-1037
Phone (336) 938-0717

Other names 1

  • Melissa Beth Dickerson Former name

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

State licenses

LicenseStateTypeSpecialty
17540ALMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1288742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1811298128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 N CHURCH ST STE 300",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011037",
            "telephone_number": "336-938-0717",
            "fax_number": "336-938-0757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 N CHURCH ST STE 300",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011037",
            "telephone_number": "336-938-0717",
            "fax_number": "336-938-0757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACCIA",
        "first_name": "MELISSA",
        "middle_name": "DICKERSON",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-03",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "17540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "DICKERSON",
            "middle_name": "BETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; 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.