Individual provider Active NPI

Melanie Ruth Sida, R.N., CPNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1063744357
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APN.0003861-NP Issued in CO
Practice address
9544 Newport Plum CT
Colorado Springs, CO 80920-2806
Phone
(720) 450-6021
NPI assigned
Feb 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN.0003861-NP CO Primary

Addresses

Primary practice location

9544 Newport Plum CT
Colorado Springs, CO 80920-2806

Mailing address

9544 Newport Plum CT
Colorado Springs, CO 80920-2806
Phone (720) 450-6021

Other identifiers 1

IdentifierTypeStateIssuer
111251OtherCOCOLORADO NURSING LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
APN.0003861-NPCOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Center, LLC CurrentSince Apr 18, 2022 Accepting new patients
Family Care Center, LLC Psychiatric/Mental Health CurrentSince Apr 18, 2022 Accepting new patients

Locations

2860 S Circle Dr
Ste 109
Colorado Springs, CO 80906
Phone 71954021004002

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1265846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1063744357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9544 NEWPORT PLUM CT",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809202806",
            "telephone_number": "720-450-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9544 NEWPORT PLUM CT",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809202806",
            "telephone_number": "720-450-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDA",
        "first_name": "MELANIE",
        "middle_name": "RUTH",
        "name_prefix": "Ms.",
        "credential": "R.N., CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-11",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.0003861-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO NURSING LICENSE",
            "identifier": "111251",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.