Individual provider Active NPI

Patricia N. Melosh

  • Registered Nurse
  • Santa Rosa, CA
National Provider Identifier
1629132055
Registry record updated Aug 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
258688 Issued in CA
Practice address
625 5TH St
Santa Rosa, CA 95404-4428
Phone
(707) 565-4450
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 258688 CA Primary
Community Health Registered Nurse 163WC1500X 258688 CA

Addresses

Primary practice location

625 5TH St
Santa Rosa, CA 95404-4428

Mailing address

625 5TH St
Santa Rosa, CA 95404-4428

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

State licenses

LicenseStateTypeSpecialty
258688CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1629132055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 5TH ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 5TH ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044428",
            "telephone_number": "707-565-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELOSH",
        "first_name": "PATRICIA",
        "middle_name": "N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "258688",
            "primary": true
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "258688",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; 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.