Individual provider Active NPI

Melissa Reynolds

  • Licensed Practical Nurse
  • Charleston, WV
National Provider Identifier
1992502694
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
31378 Issued in WV
Practice address
900 Virginia St E Ste 400
Charleston, WV 25301-2835
Phone
(681) 313-4759
NPI assigned
Feb 28, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 183134 OH
Licensed Practical Nurse 164W00000X 31378 WV Primary

Addresses

Primary practice location

900 Virginia St E Ste 400
Charleston, WV 25301-2835

Mailing address

55 Township Road 341
Proctorville, OH 45669-9094
Phone (304) 633-5566

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL MaximCareMobile

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

LicenseStateTypeSpecialty
183134OHMDLicensed Practical Nurse
31378WVMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1740700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1992502694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 TOWNSHIP ROAD 341",
            "city": "PROCTORVILLE",
            "state": "OH",
            "postal_code": "456699094",
            "telephone_number": "304-633-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 VIRGINIA ST E STE 400",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253012835",
            "telephone_number": "681-313-4759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "MELISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-28",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "183134",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WV",
            "license": "31378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "MaximCareMobile",
            "affiliation": "N",
            "address_1": "900 Virginia St E Ste 400",
            "city": "Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253012835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; 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.