Individual provider Active NPI

Melissa Dodson, NP

  • Acute Care Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1306204698
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95002906 Issued in CA
Practice address
3747 Worsham Ave Ste 100
Long Beach, CA 90808-1734
Phone
(562) 430-4513
NPI assigned
Feb 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95002906 CA Primary

Addresses

Primary practice location

3747 Worsham Ave Ste 100
Long Beach, CA 90808-1734

Mailing address

3747 Worsham Ave Ste 100
Long Beach, CA 90808-1734
Phone (562) 430-4513

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
I20161020002396 CA Practitioner - Nurse Practitioner 8921386277 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95002906CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southland Neurologic Institute Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16722/brand/3/csg/1/fhir/r4
  • Direct secure messaging: melissa.dodson.1@16722.direct.athenahealth.com

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": "1454371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1306204698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3747 WORSHAM AVE STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081734",
            "telephone_number": "562-430-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3747 WORSHAM AVE STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081734",
            "telephone_number": "562-430-4513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODSON",
        "first_name": "MELISSA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-02",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95002906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.