Individual provider Active NPI

Melissa Diane Meehan, MSN, RN, CNS

  • Medical-Surgical Clinical Nurse Specialist
  • San Diego, CA
National Provider Identifier
1790131373
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Clinical Nurse SpecialistTaxonomy code 364SM0705X
License
4444 Issued in CA
Practice address
2681 W Canyon Ave
Apt 547
San Diego, CA 92123-4736
Phone
(760) 846-4098
NPI assigned
May 12, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 415908 CA
Medical-Surgical Clinical Nurse Specialist 364SM0705X 4444 CA Primary

Addresses

Primary practice location

2681 W Canyon Ave
Apt 547
San Diego, CA 92123-4736

Mailing address

2681 W Canyon Ave
Apt 547
San Diego, CA 92123-4736
Phone (760) 846-4098

Other names 1

  • Melissa Diane Drake Other name

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
Certified Nurse Specialist, Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
415908CAMDMedical-Surgical Registered Nurse
4444CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1790131373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2681 W CANYON AVE",
            "address_2": "APT 547",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234736",
            "telephone_number": "760-846-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2681 W CANYON AVE",
            "address_2": "APT 547",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234736",
            "telephone_number": "760-846-4098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEEHAN",
        "first_name": "MELISSA",
        "middle_name": "DIANE",
        "credential": "MSN, RN, CNS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-12",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "CA",
            "license": "415908",
            "primary": false
        },
        {
            "code": "364SM0705X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Medical-Surgical",
            "state": "CA",
            "license": "4444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "DRAKE",
            "middle_name": "DIANE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; 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.