Individual provider Active NPI

Melissa McGill Gonzalez, R.N.

  • Women's Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1578716874
Registry record updated Oct 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
252463 Issued in TX
Practice address
12647 Olive Blvd
Suite 600
Saint Louis, MO 63141-6393
Phone
(210) 308-9193
NPI assigned
Oct 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2008

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 252463 TX Primary

Addresses

Primary practice location

12647 Olive Blvd
Suite 600
Saint Louis, MO 63141-6393

Mailing address

622 Glencrest Dr
San Antonio, TX 78229-4214
Phone (210) 308-9193

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
252463TXMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1225324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225324800000",
    "number": "1578716874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 GLENCREST DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294214",
            "telephone_number": "210-308-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12647 OLIVE BLVD",
            "address_2": "SUITE 600",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416393",
            "telephone_number": "210-308-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MELISSA",
        "middle_name": "MCGILL",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-30",
        "last_updated": "2008-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "252463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2008; 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.