Active NPI
Melissa Gail Cavanaugh, RN
- Registered Nurse
- Ft. Rucker, AL
National Provider Identifier
1710282512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 1-064153
- Practice address
- Building 301 Andrews Ave.
Lyster Army Health Clinic
Ft. Rucker, AL 36362 - Phone
- (334) 255-7383
- NPI assigned
- Jan 26, 2011
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 1-064153 | AL | Primary |
Addresses
Primary practice location
Building 301 Andrews Ave.
Lyster Army Health Clinic
Ft. Rucker, AL 36362
Mailing address
Building 301 Andrews Ave.
Lyster Army Health Clinic
Enterprise, AL 36330
Phone (334) 379-5249
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-064153 | AL | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296000000000",
"number": "1710282512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BUILDING 301 ANDREWS AVE.",
"address_2": "LYSTER ARMY HEALTH CLINIC",
"city": "ENTERPRISE",
"state": "AL",
"postal_code": "36330",
"telephone_number": "334-379-5249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BUILDING 301 ANDREWS AVE.",
"address_2": "LYSTER ARMY HEALTH CLINIC",
"city": "FT. RUCKER",
"state": "AL",
"postal_code": "36362",
"telephone_number": "334-255-7383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAVANAUGH",
"first_name": "MELISSA",
"middle_name": "GAIL",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-26",
"last_updated": "2011-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "AL",
"license": "1-064153",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ft. Rucker, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.