Individual provider Active NPI

Melanie S Wice, NP RN CNM

  • Advanced Practice Midwife
  • Larkspur, CA
National Provider Identifier
1750484929
Registry record updated Aug 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
937 Issued in CA
Practice address
5 Bon Air Rd
Suite 217
Larkspur, CA 94939-1143
Phone
(415) 945-2114
Fax
(415) 924-2021
NPI assigned
Sep 6, 2006
Last updated
Aug 7, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Women's Health Care Registered Nurse 163WW0101X 428287 CA
Women's Health Nurse Practitioner 363LW0102X 7152 CA
Advanced Practice Midwife 367A00000X 937 CA Primary

Addresses

Primary practice location

5 Bon Air Rd
Suite 217
Larkspur, CA 94939-1143

Mailing address

5 Bon Air Rd
Suite 217
Larkspur, CA 94939-1143
Phone (415) 945-2114

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 Midwife, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
7152CAMDAddiction (Substance Use Disorder) Counselor
937CAMDDental Hygienist
428287CAMDAmbulatory Women's Health Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312675200000",
    "number": "1750484929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BON AIR RD",
            "address_2": "SUITE 217",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949391143",
            "telephone_number": "415-945-2114",
            "fax_number": "415-924-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BON AIR RD",
            "address_2": "SUITE 217",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949391143",
            "telephone_number": "415-945-2114",
            "fax_number": "415-924-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICE",
        "first_name": "MELANIE",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "NP RN CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2011-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "CA",
            "license": "428287",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "7152",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Larkspur, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.

Verify at the official NPI Registry.