Active NPI
Melissa M Coale, MD
- Dermatology Physician
- Concord, NC
National Provider Identifier
1881670115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 98-00025
- Practice address
- 335 Penny LN
Concord, NC 28025-1221 - Phone
- (704) 784-5901
- Fax
- (704) 721-0413
- NPI assigned
- Dec 19, 2005
- Last updated
- Feb 12, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 98-00025 | NC | Primary |
| Procedural Dermatology Physician | 207NS0135X | 98-00025 | NC |
Addresses
Primary practice location
335 Penny LN
Concord, NC 28025-1221
Mailing address
335 Penny LN
Concord, NC 28025-1221
Phone (704) 784-5901
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 70011976 | Other | NC | MEDICARE RAILROAD |
| 891136L | Medicaid | NC |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 98-00025 | NC | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234396800000",
"number": "1881670115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "335 PENNY LN",
"city": "CONCORD",
"state": "NC",
"postal_code": "280251221",
"telephone_number": "704-784-5901",
"fax_number": "704-721-0413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "335 PENNY LN",
"city": "CONCORD",
"state": "NC",
"postal_code": "280251221",
"telephone_number": "704-784-5901",
"fax_number": "704-721-0413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COALE",
"first_name": "MELISSA",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-19",
"last_updated": "2009-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NC",
"license": "98-00025",
"primary": true
},
{
"code": "207NS0135X",
"taxonomy_group": "",
"desc": "Dermatology, Procedural Dermatology",
"state": "NC",
"license": "98-00025",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "70011976",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891136L",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Concord, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.