Active NPI
Melissa Anne Patterson
- Nursing Care Agency
- Port Orange, FL
National Provider Identifier
1679646087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Care Agency
- License
- CNA103063
- Practice address
- 22 Raintree Dr
Port Orange, FL 32127-5937 - Phone
- (386) 295-0337
- NPI assigned
- Nov 15, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Care Agency | 251J00000X | CNA103063 | FL | Primary |
Addresses
Primary practice location
22 Raintree Dr
Port Orange, FL 32127-5937
Mailing address
22 Raintree Dr
Port Orange, FL 32127-5937
Phone (386) 295-0337
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CNA103063 | Other | FL | CERTIFIED NURSING ASSISTA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| CNA103063 | FL | MD | Nursing Care Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339459200000",
"number": "1679646087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 RAINTREE DR",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321275937",
"telephone_number": "386-295-0337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 RAINTREE DR",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321275937",
"telephone_number": "386-295-0337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTERSON",
"first_name": "MELISSA",
"middle_name": "ANNE",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-15",
"last_updated": "2012-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": "FL",
"license": "CNA103063",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFIED NURSING ASSISTA",
"identifier": "CNA103063",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Port Orange, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.