Individual provider Active NPI

Melinda Jill Porter, RN, NNP-BC, CNS

  • Neonatal Clinical Nurse Specialist
  • San Leandro, CA
National Provider Identifier
1659550747
Registry record updated Nov 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Clinical Nurse SpecialistTaxonomy code 364SN0000X
License
1689 Issued in CA
Practice address
2500 Merced Street
3Rd Floor, Nicu
San Leandro, CA 94577-4201
Phone
(510) 454-3546
NPI assigned
Oct 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN536076 CA
Critical Care Neonatal Nurse Practitioner 363LN0005X 13535 CA
Neonatal Clinical Nurse Specialist 364SN0000X 1689 CA Primary

Addresses

Primary practice location

2500 Merced Street
3Rd Floor, Nicu
San Leandro, CA 94577-4201

Mailing address

2500 Merced Street
3Rd Floor, Nicu
San Leandro, CA 94577-4201
Phone (510) 454-3546

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
Certified Nurse Specialist, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN536076CAMDRegistered Nurse
1689CAMDCommunity Health Worker
13535CAMDCritical Care Neonatal Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447286400000",
    "number": "1659550747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MERCED STREET",
            "address_2": "3RD FLOOR, NICU",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774201",
            "telephone_number": "510-454-3546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 MERCED STREET",
            "address_2": "3RD FLOOR, NICU",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774201",
            "telephone_number": "510-454-3546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "MELINDA",
        "middle_name": "JILL",
        "credential": "RN, NNP-BC, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-25",
        "last_updated": "2015-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN536076",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "CA",
            "license": "13535",
            "primary": false
        },
        {
            "code": "364SN0000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Neonatal",
            "state": "CA",
            "license": "1689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.