Individual provider Active NPI

Melody Callison

  • Community Health Worker
  • Redding, CA
National Provider Identifier
1710573175
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
1110 Shasta St
Redding, CA 96001-0808
Phone
(530) 768-1880
NPI assigned
Dec 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

1110 Shasta St
Redding, CA 96001-0808

Mailing address

1321 Murfreesboro Pike Ste 702
Nashville, TN 37217-2679
Phone (844) 359-7629

Other practice location 1

17B Caledon Ct
Greenville, SC 29615-3170
Phone (864) 631-2084

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

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Legacy Center CurrentSince Jan 15, 2023 Accepting new patients

Locations

1110 Shasta St
Redding, CA 96001
Phone (530) 410-9224

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1608249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1710573175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 MURFREESBORO PIKE STE 702",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372172679",
            "telephone_number": "844-359-7629",
            "fax_number": "615-815-1946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 SHASTA ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010808",
            "telephone_number": "530-768-1880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17B Caledon Ct",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296153170",
            "country_code": "US",
            "telephone_number": "864-631-2084",
            "fax_number": "615-815-1946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALLISON",
        "first_name": "MELODY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-18",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.