Active NPI
Melissa Dedeaux, CRNFA
- Registered Nurse First Assistant
- Meridian, MS
National Provider Identifier
1962045765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse First Assistant
- License
- 866162
- Practice address
- 2124 14TH St
Meridian, MS 39301-4040 - Phone
- (601) 553-6000
- Fax
- (601) 703-0124
- NPI assigned
- Oct 24, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse First Assistant | 163WR0006X | 866162 | MS | Primary |
Addresses
Primary practice location
2124 14TH St
Meridian, MS 39301-4040
Mailing address
2124 14TH St
Meridian, MS 39301-4040
Phone (601) 553-6000
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 866162 | MS | MD | Registered Nurse First Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571875200000",
"number": "1962045765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2124 14TH ST",
"city": "MERIDIAN",
"state": "MS",
"postal_code": "393014040",
"telephone_number": "601-553-6000",
"fax_number": "601-703-0124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2124 14TH ST",
"city": "MERIDIAN",
"state": "MS",
"postal_code": "393014040",
"telephone_number": "601-553-6000",
"fax_number": "601-703-0124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEDEAUX",
"first_name": "MELISSA",
"credential": "CRNFA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-24",
"last_updated": "2019-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "163WR0006X",
"taxonomy_group": "",
"desc": "Registered Nurse, Registered Nurse First Assistant",
"state": "MS",
"license": "866162",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meridian, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.