Individual provider Active NPI

Melissa A Bown, ANP

  • Adult Health Nurse Practitioner
  • Johnstown, NY
National Provider Identifier
1578781985
Registry record updated Jan 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F302577 Issued in NY
Practice address
23 S Perry St
Johnstown, NY 12095-2316
Phone
(518) 736-1500
Fax
(518) 762-8194
NPI assigned
Apr 23, 2007
Last updated
Jan 21, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F302577 NY Primary

Addresses

Primary practice location

23 S Perry St
Johnstown, NY 12095-2316

Mailing address

99 E State St
PO Box 1250
Gloversville, NY 12078-1203
Phone (518) 736-1500

Other identifiers 1

IdentifierTypeStateIssuer
01993677MedicaidNY

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nathan Littauer Hospital Association 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, 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": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1578781985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 E STATE ST",
            "address_2": "PO BOX 1250",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120781203",
            "telephone_number": "518-736-1500",
            "fax_number": "518-762-8194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 S PERRY ST",
            "city": "JOHNSTOWN",
            "state": "NY",
            "postal_code": "120952316",
            "telephone_number": "518-736-1500",
            "fax_number": "518-762-8194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWN",
        "first_name": "MELISSA",
        "middle_name": "A",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F302577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01993677",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.