Individual provider Active NPI

Melissa Sy, RN

  • Nursing Care Agency
  • Portland, OR
National Provider Identifier
1386026011
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
15-2297 Issued in OR
Practice address
15915 NE Glisan St
Portland, OR 97230
Phone
(503) 206-7693
NPI assigned
Jun 18, 2015
Last updated
Jun 18, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X 15-2297 OR Primary

Addresses

Primary practice location

15915 NE Glisan St
Portland, OR 97230

Mailing address

15915 NE Glisan St
Portland, OR 97230
Phone (503) 206-7693

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
15-2297ORMDNursing Care Agency

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1386026011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15915 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97230",
            "telephone_number": "503-206-7693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15915 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97230",
            "telephone_number": "503-206-7693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SY",
        "first_name": "MELISSA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-18",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "OR",
            "license": "15-2297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2015; 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.