Individual provider Active NPI

Melanie Rose Dart, PA-C

  • Physician Assistant
  • Wilmington, NC
National Provider Identifier
1942466909
Registry record updated May 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-03519 Issued in NC
Practice address
1709 S 16TH St
Suite a
Wilmington, NC 28401-6472
Phone
(910) 452-8633
Fax
(910) 452-8569
NPI assigned
Jul 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-03519 NC Primary

Addresses

Primary practice location

1709 S 16TH St
Suite a
Wilmington, NC 28401-6472

Mailing address

PO Box 15109
Wilmington, NC 28408-5109
Phone (910) 392-2525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20120809000601 NC Practitioner - Physician Assistant 4789759135 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

101 Clinic Dr
Tarboro, NC 27886-1935
Phone (252) 823-2105

2460 Emerald PL
Greenville, NC 27834-5784
Phone (252) 830-2021

401 A N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

401 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

417 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-8080

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-03519NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Outer Banks Professional Services, LLC CurrentSince Jul 1, 2022 Accepting new patients
Vidant Medical Group LLC CurrentSince Oct 2, 2017 Accepting new patients
Bellin Memorial Hospital Inc Past Accepting new patients
Advanced Pain Management SC Past Accepting new patients

Locations

2460 Emerald Pl
Greenville, NC 27834
Phone (252) 695-6000

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

1473 NC 42 43 W
Pinetops, NC 27864
Phone (252) 641-8585

5565 N Croatan Hwy
Southrn Shore, NC 27949
Phone (252) 261-5800

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 2

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": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337904000000",
    "number": "1942466909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15109",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284085109",
            "telephone_number": "910-392-2525",
            "fax_number": "910-392-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 S 16TH ST",
            "address_2": "SUITE A",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016472",
            "telephone_number": "910-452-8633",
            "fax_number": "910-452-8569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DART",
        "first_name": "MELANIE",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2012-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.