NPIMap

Individual provider Active NPI

Melissa A Callahan, CRNP

  • Gerontology Nurse Practitioner
  • Exton, PA
National Provider Identifier
1669411393
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
TP006181H Issued in PA
Practice address
320 Exton CMNS
Exton, PA 19341-2450
Phone
(866) 268-6609
Fax
(866) 610-4542
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X TP006181H PA Primary
Adult Health Nurse Practitioner 363LA2200X TP006182C PA

Addresses

Primary practice location

320 Exton CMNS
Exton, PA 19341-2450

Mailing address

320 Exton CMNS
Exton, PA 19341-2450
Phone (866) 268-6609

Other identifiers 2

IdentifierTypeStateIssuer
102510472 0001OtherPAPROMISE NUMBER
032688YCCWOtherPAMEDICARE NUMBER

Other names 1

  • Melissa A Henofer Former name

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
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ocular Telehealth PC Past Accepting new patients
Wills Eye Ophthalmology Clinic, Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1669411393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 EXTON CMNS",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193412450",
            "telephone_number": "866-268-6609",
            "fax_number": "866-610-4542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 EXTON CMNS",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193412450",
            "telephone_number": "866-268-6609",
            "fax_number": "866-610-4542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "MELISSA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "TP006181H",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "TP006182C",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROMISE NUMBER",
            "identifier": "102510472 0001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "032688YCCW",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "HENOFER",
            "middle_name": "A",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Exton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; 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.