Individual provider Active NPI

Melissa Sloan, FNP

  • Family Nurse Practitioner
  • Willows, CA
National Provider Identifier
1417940040
Registry record updated Oct 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
295558 Issued in CA
Practice address
207 N Butte St
Willows, CA 95988-2803
Phone
(530) 934-4641
Fax
(530) 934-4081
NPI assigned
Aug 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 295558 CA Primary

Addresses

Primary practice location

207 N Butte St
Willows, CA 95988-2803

Mailing address

207 N Butte St
Willows, CA 95988-2803
Phone (530) 934-4641

Other names 1

  • Melissa Epidendio Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mepidendiosloan1647958@oc.providencedirect.org

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
I20110215000065 CA Practitioner - Nurse Practitioner 0749460319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 546-3210

200 W Ctr St Promenade
Anaheim, CA 92805-3960

500 Doyle Park Dr
Santa Rosa, CA 95405-4559

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Apr 13, 2013 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Apr 13, 2013 Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Providence Medical Foundation Past Accepting new patients
Annadel Medical Group, Inc Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

585 W College Ave
Ste A
Santa Rosa, CA 95401
Phone (707) 525-9616

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

8911 Lakewood Dr
Ste 13
Windsor, CA 95492
Phone (707) 387-3910

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634860800000",
    "number": "1417940040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 N BUTTE ST",
            "city": "WILLOWS",
            "state": "CA",
            "postal_code": "959882803",
            "telephone_number": "530-934-4641",
            "fax_number": "530-934-4081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 N BUTTE ST",
            "city": "WILLOWS",
            "state": "CA",
            "postal_code": "959882803",
            "telephone_number": "530-934-4641",
            "fax_number": "530-934-4081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOAN",
        "first_name": "MELISSA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "295558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mepidendiosloan1647958@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "585 W College Ave Ste A",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954015060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "EPIDENDIO",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Willows, CA

Sources for this page

Verify at the official NPI Registry.