Individual provider Active NPI

Melissa Ann Sorensen, RN

  • Registered Nurse
  • Modesto, CA
National Provider Identifier
1265767669
Registry record updated Oct 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
751455 Issued in CA
Practice address
1540 Florida Ave
Suite 100
Modesto, CA 95350-4430
Phone
(209) 577-5557
Fax
(207) 577-8125
NPI assigned
Oct 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 751455 CA Primary

Addresses

Primary practice location

1540 Florida Ave
Suite 100
Modesto, CA 95350-4430

Mailing address

1540 Florida Ave
Suite 100
Modesto, CA 95350-4430
Phone (209) 577-5557

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
751455CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Medical Center of Modesto Past Accepting new patients
Valley Heart Associates Medical Group Inc PastSince Oct 23, 2006 Accepting new patients

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": "1254441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254441600000",
    "number": "1265767669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 FLORIDA AVE",
            "address_2": "SUITE 100",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504430",
            "telephone_number": "209-577-5557",
            "fax_number": "209-577-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 FLORIDA AVE",
            "address_2": "SUITE 100",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504430",
            "telephone_number": "209-577-5557",
            "fax_number": "207-577-8125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSEN",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-02",
        "last_updated": "2009-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "751455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2009; 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.