Active NPI
Melissa McCormick
- Family Nurse Practitioner
- Providence, RI
National Provider Identifier
1962230078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN04064
- Practice address
- 1085 N Main St
Providence, RI 02904-5719 - Phone
- (401) 415-4200
- NPI assigned
- Jul 22, 2024
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN04064 | RI | Primary |
Addresses
Primary practice location
1085 N Main St
Providence, RI 02904-5719
Mailing address
1085 N Main St
Providence, RI 02904-5719
Phone (401) 415-4200
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN04064 | RI | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722038400000",
"number": "1962230078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1085 N MAIN ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029045719",
"telephone_number": "401-415-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1085 N MAIN ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029045719",
"telephone_number": "401-415-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCORMICK",
"first_name": "MELISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-22",
"last_updated": "2024-07-27",
"certification_date": "2024-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "RI",
"license": "APRN04064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.