Individual provider Active NPI

Melinda Goodwin Sheehan, FNP

  • Family Nurse Practitioner
  • Santa Rosa, CA
National Provider Identifier
1629182621
Registry record updated Dec 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7068 Issued in CA
Practice address
144 Stony Point Rd
Santa Rosa, CA 95401-4122
Phone
(707) 521-4500
Fax
(707) 544-4626
NPI assigned
Aug 18, 2006
Last updated
Dec 19, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2012

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 7068 CA Primary

Addresses

Primary practice location

144 Stony Point Rd
Santa Rosa, CA 95401-4122

Mailing address

144 Stony Point Rd
Santa Rosa, CA 95401-4122
Phone (707) 521-4500

Other identifiers 5

IdentifierTypeStateIssuer
1629182621MedicaidCA
406306OtherCAREGISTERED NURSE LICENSE
NP0070680OtherCABLUE SHIELD OF CALIFORNIA
P00653931OtherCARAILROAD MEDICARE
NPF 7068OtherCANURSE PRACTIONER NUMBER

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

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1629182621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 STONY POINT RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014122",
            "telephone_number": "707-521-4500",
            "fax_number": "707-544-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 STONY POINT RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014122",
            "telephone_number": "707-521-4500",
            "fax_number": "707-544-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEEHAN",
        "first_name": "MELINDA",
        "middle_name": "GOODWIN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "7068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629182621",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE",
            "identifier": "406306",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "NP0070680",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00653931",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTIONER NUMBER",
            "identifier": "NPF 7068",
            "state": "CA"
        }
    ],
    "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 Dec 19, 2012; 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.