NPIMap

Organization Active NPI

Melissa Stockman Adult Care NP PC

  • Adult Health Nurse Practitioner
  • Medford, NY
National Provider Identifier
1952780736
Registry record updated May 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F302133-1 Issued in NY
Legal business name
MELISSA STOCKMAN ADULT CARE NP PC
Practice address
41 Greenport Ave
Medford, NY 11763-3601
Phone
(631) 758-5635
NPI assigned
May 26, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2015

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

Authorized official

Name
Melissa Sonya Stockman, MS, RN CS, ANP, PNPNPI 1205054137
Title
Owner
Phone
(631) 758-5635

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X F302133-1 NY Primary
Pediatric Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0200X F381245-1 NY

Addresses

Primary practice location

41 Greenport Ave
Medford, NY 11763-3601

Mailing address

41 Greenport Ave
Medford, NY 11763-3601
Phone (631) 758-5635

National Provider Directory

National Provider Directory
Tax ID family
Melissa Stockman Adult Care NP PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432598400000",
    "number": "1952780736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 GREENPORT AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117633601",
            "telephone_number": "631-758-5635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 GREENPORT AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117633601",
            "telephone_number": "631-758-5635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELISSA STOCKMAN ADULT CARE NP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-26",
        "last_updated": "2015-05-26",
        "status": "A",
        "authorized_official_last_name": "STOCKMAN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "SONYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-758-5635",
        "authorized_official_credential": "MS, RN CS, ANP, PNP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F302133-1",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F381245-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; 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.