MELISSA ROE (NPI# 1336510916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336510916 |
| Entity Type | Individual |
| Full Name | MELISSA ROE |
| Credential | PA |
| Practice Address |
4110 Medical Center Dr Fayetteville NY 13066-6613 |
| Practice Telephone | 3156630100 |
| Mailing Telephone | 3156630100 |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2018-01-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 019250 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699191940 | Melissa Roe | Registered Nurse | 1959 Ne Pacific St Ofc Nn519, Box 356079, Seattle, WA 98195-6079 | 2014-03-11 |
| Street Address |
4110 MEDICAL CENTER DR |
| City | FAYETTEVILLE |
| State | NY |
| Zip Code | 13066-6613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376537308 | Vadjista Broumand | Internal Medicine | 4110 Medical Center Dr, Suite 110, Fayetteville, NY 13066 | 2005-09-06 |
| 1871848481 | Meghan L Doran | Nurse Practitioner | 4110 Medical Center Dr, Suite 100, Fayetteville, NY 13066-6613 | 2012-07-19 |
| 1023247608 | Jessica Faye Bouchard | Physician Assistant | 4110 Medical Center Dr, Fayetteville, NY 13066-6613 | 2009-07-05 |
| 1558507251 | Rachel Marie Damon | Physician Assistant | 4110 Medical Center Dr, Fayetteville, NY 13066-6613 | 2008-12-30 |
| 1336235639 | Dermatology Associates of Central New York Pllc | Dermatology | 4110 Medical Center Dr, Fayetteville, NY 13066-6613 | 2006-10-05 |
| 1992756209 | Ellen E Powers | Nurse Practitioner | 4110 Medical Center Dr, Fayetteville, NY 13066-6613 | 2006-05-12 |
| 1215991005 | Amin Fazeli | Dermatology | 4110 Medical Center Dr, Suite 110, Fayetteville, NY 13066-6613 | 2006-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457819963 | Word Wellness Center, LLC | Psychologist | 6836 E Genesee Street, Suite A, Fayetteville, NY 13066 | 2019-03-05 |
| 1629529060 | Lorna Boyer Chase | Marriage & Family Therapist | 109 White Heron Circle, Fayetteville, NY 13066 | 2016-10-20 |
| 1699221432 | Roman Batyuk | Nurse Practitioner | 4100 Medical Center Drive, Fayetteville, NY 13066 | 2016-08-31 |
| 1427405133 | National Eye Care, Inc | Optometrist | 5160 Kinloch Circle, Fayetteville, NY 13066 | 2016-05-23 |
| 1013375328 | Kristin Kukenberger | Chiropractor | 7000 E Genesee St Bldg B, Fayetteville, NY 13066 | 2016-02-01 |
| 1124394671 | Susan Hartman Brenizer | Marriage & Family Therapist | 7000 E Genesee St Lyndon Office Park, Bldg. A, Second Floor (upper Level), Fayetteville, NY 13066 | 2012-03-29 |
| 1245541432 | Rene L Converse | Occupational Therapist | 7200 E. Genesee Street, Fayetteville, NY 13066 | 2010-06-23 |
| 1689815805 | Menorah Park Group Residents | Clinic/Center | 12 Jamar Drive, Dewitt, NY 13066 | 2009-03-18 |
| 1063677458 | John Marcena Glezen | Obstetrics & Gynecology | 1 The Gazebo, Fayetteville, NY 13066 | 2008-07-24 |
| 1629232418 | Tucker Martin Harris | Otolaryngology | 4000 Medical Center Dr # 117, Fayetteville, NY 13066 | 2008-07-11 |
| Find all providers in zip 13066 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306443387 | Melissa Macneil Spencer | Physician Assistant | 810 Knighthood Cir, Fayetteville, NY 13066-8721 | 2020-10-03 |
| 1366067548 | Prathna Raval | Physician Assistant | 6808 Thames Dr, Fayetteville, NC 28306-2524 | 2020-06-12 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1144858515 | Mackenzie Anna Kirchner | Physician Assistant | 568 Sandy Creek Rd, Fayetteville, GA 30214-4205 | 2020-03-31 |
| 1770116931 | Chasity Nicole Sullivan | Physician Assistant | 202b Highland Ave, Fayetteville, NC 28305-5308 | 2020-02-17 |
| 1740812833 | Madeline Everitt Monday | Physician Assistant | 705 Stonington Dr, Fayetteville, NC 28311-0329 | 2020-02-07 |
| 1396375325 | Lisa Ann Gross | Physician Assistant | 3007 Town Center Dr Ste 100, Fayetteville, NC 28306-3663 | 2020-01-17 |
| 1811536048 | Kelly Hamilton Sweatt | Physician Assistant | 1991 Fordham Dr Ste 200, Fayetteville, NC 28304-3774 | 2020-01-06 |
| 1922563667 | Reandy Nicole Hearn | Physician Assistant | 2911 Breezewood Ave Ste 100, Fayetteville, NC 28303-5464 | 2019-02-06 |
| 1790259430 | Cassandra Ann Nebosky-diaz | Physician Assistant | 659 Daharan Dr, Fayetteville, NC 28314-6538 | 2019-01-16 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 13066 |
Please comment or provide details below to improve the information on MELISSA ROE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.