Individual provider Active NPI

Melissa Diana Patera, RN

  • Case Management Registered Nurse
  • Fond Du Lac, WI
National Provider Identifier
1407166747
Registry record updated Oct 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management Registered NurseTaxonomy code 163WC0400X
License
174166-30 Issued in WI
Practice address
N6654 Rolling Meadows Dr
Fond Du Lac, WI 54937-9471
Phone
(920) 906-5100
NPI assigned
Oct 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X 174166-30 WI Primary

Addresses

Primary practice location

N6654 Rolling Meadows Dr
Fond Du Lac, WI 54937-9471

Mailing address

N6654 Rolling Meadows Dr
Fond Du Lac, WI 54937-9471
Phone (920) 906-5100

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
174166-30WIMDCase Management Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Care Inc Past Accepting new patients

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": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287532800000",
    "number": "1407166747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N6654 ROLLING MEADOWS DR",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549379471",
            "telephone_number": "920-906-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N6654 ROLLING MEADOWS DR",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549379471",
            "telephone_number": "920-906-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATERA",
        "first_name": "MELISSA",
        "middle_name": "DIANA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-20",
        "last_updated": "2010-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "WI",
            "license": "174166-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; 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.