Individual provider Active NPI

Melissa Lynn Fannon-Wisner, CRNP

  • Family Nurse Practitioner
  • Winchester, VA
National Provider Identifier
1891245981
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
105608 Issued in WV
Practice address
190 Campus Blvd Ste 400
Winchester, VA 22601-2872
Phone
(540) 667-1727
Fax
(540) 722-3373
NPI assigned
Oct 12, 2016
Last updated
Feb 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AC003394 MD
Family Nurse Practitioner 363LF0000X SP016840 PA
Family Nurse Practitioner 363LF0000X 105608 WV Primary
Family Nurse Practitioner 363LF0000X 0024185033 VA

Addresses

Primary practice location

190 Campus Blvd Ste 400
Winchester, VA 22601-2872

Mailing address

190 Campus Blvd Ste 400
Winchester, VA 22601-2872
Phone (540) 667-1727

Other practice location 1

19820 Century Blvd
Germantown, MD 20874-1198
Phone (301) 528-5437

Other practice location 2

19800 Belmont Chase Dr Ste 110
Ashburn, VA 20147-3416
Phone (703) 723-6767

Other practice location 3

12254 Rockville Pike
Rockville, MD 20852-1608
Phone (301) 230-2767

Other names 1

  • Miss Melissa Lynn Fannon Former name

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address mfannon701554@soc.inova.org
Direct Messaging Address mfannon701554@soc.inova.org
Direct Messaging Address mfannon701554@soc.inova.org

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
I20200514002140 WV Practitioner - Nurse Practitioner 7719247261 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP016840PAMDFamily Nurse Practitioner
0024185033VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Mountain Health Physicians Inc CurrentSince Jun 1, 2020 Accepting new patients
East Mountain Health Physicians Inc. Current Accepting new patients
East Mountain Health Physicians, Inc. CurrentSince Jun 1, 2020 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
East Mountain Health Physicians, Inc. Past Accepting new patients
PM Pediatrics of Virginia PastSince Aug 5, 2020 Accepting new patients

Locations

220 Campus Blvd
Ste 100
Winchester, VA 22601

4803 Gerrardstown Rd
Inwood, WV 25428
Phone (304) 821-9011

1004 Sushruta Dr
Ste D
Martinsburg, WV 25401
Phone (304) 262-2538

101 Marcley Dr
Martinsburg, WV 25401
Phone (304) 263-8911

120 Campus Dr
Ste 211
Martinsburg, WV 25404
Phone (681) 247-1260

120 Campus Dr
Ste 221
Martinsburg, WV 25404
Phone (681) 247-1280

100 Oak Lee Dr
Ranson, WV 25438
Phone (304) 350-0001

Interoperability endpoints

  • Direct secure messaging: mfannon701554@soc.inova.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770249600000",
    "number": "1891245981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 CAMPUS BLVD STE 400",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012872",
            "telephone_number": "540-667-1727",
            "fax_number": "540-722-3373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 CAMPUS BLVD STE 400",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012872",
            "telephone_number": "540-667-1727",
            "fax_number": "540-722-3373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19820 Century Blvd",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "MD",
            "postal_code": "208741198",
            "country_code": "US",
            "telephone_number": "301-528-5437",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19800 Belmont Chase Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Ashburn",
            "state": "VA",
            "postal_code": "201473416",
            "country_code": "US",
            "telephone_number": "703-723-6767",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12254 Rockville Pike",
            "address_purpose": "LOCATION",
            "city": "Rockville",
            "state": "MD",
            "postal_code": "208521608",
            "country_code": "US",
            "telephone_number": "301-230-2767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FANNON-WISNER",
        "first_name": "MELISSA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-12",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "AC003394",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP016840",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "105608",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024185033",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mfannon701554@soc.inova.org",
            "affiliation": "N",
            "address_1": "4803 Gerrardstown Rd",
            "city": "Inwood",
            "state": "WV",
            "country_code": "US",
            "postal_code": "254283450",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mfannon701554@soc.inova.org",
            "affiliation": "N",
            "address_1": "101 Marcley Dr",
            "city": "Martinsburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "254012977",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mfannon701554@soc.inova.org",
            "affiliation": "N",
            "address_1": "120 Campus Dr Ste 221",
            "city": "Martinsburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "254047552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "FANNON",
            "middle_name": "LYNN",
            "prefix": "MISS",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.