Individual provider Active NPI

Melanie Charles, N.P.

  • Family Nurse Practitioner
  • Walnut Creek, CA
National Provider Identifier
1972792950
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
15648 Issued in CA
Practice address
1479 Ygnacio Valley Rd # 150
Walnut Creek, CA 94598
Phone
(925) 941-4167
NPI assigned
Oct 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 15648 CA
Family Nurse Practitioner 363LF0000X 15648 CA Primary

Addresses

Primary practice location

1479 Ygnacio Valley Rd # 150
Walnut Creek, CA 94598

Mailing address

1450 Treat Blvd # 300
Walnut Creek, CA 94597-2168
Phone (925) 952-2888

Other practice location 1

1656 N California Blvd
Suite 300
Walnut Creek, CA 94596-4180
Phone (925) 941-4058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190813003450 CA Practitioner - Nurse Practitioner 6002143054 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
15648CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
John Muir Physician Network CurrentSince Jun 2, 2019 Accepting new patients

Locations

2400 Balfour Rd
Ste 120
Brentwood, CA 94513
Phone (925) 308-8112

380 Civic Dr
Ste 100
Pleasant Hill, CA 94523
Phone (925) 284-3840

1479 Ygnacio Valley Rd
Ste 150
Walnut Creek, CA 94598
Phone (925) 296-7340

1450 Treat Blvd
#300
Walnut Creek, CA 94597
Phone (925) 952-2828

1656 N California Blvd
Ste 300
Walnut Creek, CA 94596
Phone (925) 941-4058

1450 Treat Blvd
#160
Walnut Creek, CA 94597
Phone (925) 296-9000

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": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1972792950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 TREAT BLVD # 300",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945972168",
            "telephone_number": "925-952-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1479 YGNACIO VALLEY RD # 150",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "94598",
            "telephone_number": "925-941-4167"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1656 N California Blvd",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Walnut Creek",
            "state": "CA",
            "postal_code": "945964180",
            "country_code": "US",
            "telephone_number": "925-941-4058",
            "fax_number": "925-941-4059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "MELANIE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-16",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "15648",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "15648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.