Active NPI
Patricia Sullivan Mellinger, RN MSN APN/CNP
- Adult Health Nurse Practitioner
- Warrenville, IL
National Provider Identifier
1700085099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 209003910
- Practice address
- 4405 Weaver Pkwy
Warrenville, IL 60555-3269 - Phone
- (630) 933-4950
- Fax
- (630) 933-4958
- NPI assigned
- Jul 16, 2007
- Last updated
- May 9, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 209003910 | IL | Primary |
Addresses
Primary practice location
4405 Weaver Pkwy
Warrenville, IL 60555-3269
Mailing address
4405 Weaver Pkwy
Warrenville, IL 60555-3269
Phone (630) 933-4950
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 041164899 | Other | IL | MEDICAID |
| F00096658 | Other | IL | MEDICARE PTAN (INDIVIDUAL) |
| 206147 | Other | IL | MEDICARE PTAN (GROUP) |
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
- Certified Nurse Practitioner, Master of Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209003910 | IL | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525824000000",
"number": "1700085099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4405 WEAVER PKWY",
"city": "WARRENVILLE",
"state": "IL",
"postal_code": "605553269",
"telephone_number": "630-933-4950",
"fax_number": "630-933-4958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4405 WEAVER PKWY",
"city": "WARRENVILLE",
"state": "IL",
"postal_code": "605553269",
"telephone_number": "630-933-4950",
"fax_number": "630-933-4958"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELLINGER",
"first_name": "PATRICIA",
"middle_name": "SULLIVAN",
"name_prefix": "Ms.",
"credential": "RN MSN APN/CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-16",
"last_updated": "2018-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "IL",
"license": "209003910",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "041164899",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN (INDIVIDUAL)",
"identifier": "F00096658",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN (GROUP)",
"identifier": "206147",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Warrenville, IL
- Megan McLaughlan, PMHNP-BC
- Lisa C. Medanic, L.C.P.C.
- Medical Staffing Network Healthcare, LLC (MSN HomeCare)
- Medical Staffing Network, Inc. (Nurses Plus)
- Avinder Singh Mehta
- Albert HKP Mensah, MD
- Breonna Metcalf, MS, LAT, ATC
- Alyssa Micek, PA-C
- Midwest Neurosurgery & Spine Specialists, PC
- Lynn M Miglets, SLP-CCC, MMEDSCI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.