Individual provider Active NPI

Susan Jean Mealy, NP

  • Women's Health Nurse Practitioner
  • Oakdale, CA
National Provider Identifier
1316090897
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
NP4670 Issued in CA
Practice address
1420 W H St
Oakdale, CA 95361-3557
Phone
(209) 848-4180
Fax
(209) 848-5338
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X NP4670 CA Primary

Addresses

Primary practice location

1420 W H St
Oakdale, CA 95361-3557

Mailing address

11530 Oak Hill Dr
Oakdale, CA 95361-9568
Phone (209) 848-9133

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP4670CAMDWomen's Health Nurse Practitioner
4670CAMDAdult Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316090897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11530 OAK HILL DR",
            "city": "OAKDALE",
            "state": "CA",
            "postal_code": "953619568",
            "telephone_number": "209-848-9133",
            "fax_number": "209-848-5338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 W H ST",
            "city": "OAKDALE",
            "state": "CA",
            "postal_code": "953613557",
            "telephone_number": "209-848-4180",
            "fax_number": "209-848-5338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEALY",
        "first_name": "SUSAN",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "NP4670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.