Individual provider Active NPI

Melissa Stephanie Datu, APN

  • Adult Health Nurse Practitioner
  • Napa, CA
National Provider Identifier
1144572876
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
NP95003243 Issued in CA
Practice address
3230 Beard Rd
Suite 1
Napa, CA 94558-3673
Phone
(707) 253-7005
Fax
(707) 253-7271
NPI assigned
Oct 4, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 209.009318 IL
Gerontology Nurse Practitioner 363LG0600X 209.009318 IL
Gerontology Nurse Practitioner 363LG0600X NP95003243 CA
Adult Health Nurse Practitioner 363LA2200X NP95003243 CA Primary

Addresses

Primary practice location

3230 Beard Rd
Suite 1
Napa, CA 94558-3673

Mailing address

3230 Beard Rd
Suite 1
Napa, CA 94558-3673
Phone (707) 253-7005

Other practice location 1

2277 Napa Vallejo Hwy
Napa, CA 94558-7555
Phone (707) 256-7780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160805002009 CA Practitioner - Nurse Practitioner 6800030677 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95003243CAMDGerontology Nurse Practitioner
209.009318ILMDGerontology Nurse Practitioner

Organizations & group practices 1

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": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1144572876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 BEARD RD",
            "address_2": "SUITE 1",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945583673",
            "telephone_number": "707-253-7005",
            "fax_number": "707-253-7271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3230 BEARD RD",
            "address_2": "SUITE 1",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945583673",
            "telephone_number": "707-253-7005",
            "fax_number": "707-253-7271"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2277 Napa Vallejo Hwy",
            "address_purpose": "LOCATION",
            "city": "Napa",
            "state": "CA",
            "postal_code": "945587555",
            "country_code": "US",
            "telephone_number": "707-256-7780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DATU",
        "first_name": "MELISSA",
        "middle_name": "STEPHANIE",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-04",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209.009318",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209.009318",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "NP95003243",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "NP95003243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Napa, CA

Sources for this page

Verify at the official NPI Registry.