Melissa Catherine Smith, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

20624 Issued in CA

Practice address

962 Sebastapol Road
Santa Rosa, CA 95407-6829

Phone

(707) 578-2005

NPI assigned

Apr 22, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Community Action Partnership of Sonoma County

  • Community Health Clinic/Center
  • Santa Rosa, CA
  • NPI 1598807190
  NPD (past)

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

{
    "created_epoch": "1303430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303430400000",
    "number": "1992096093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 FUNSTON AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941224629",
            "telephone_number": "530-574-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "962 SEBASTAPOL ROAD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954076829",
            "telephone_number": "707-578-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MELISSA",
        "middle_name": "CATHERINE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-22",
        "last_updated": "2011-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "20624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lydia Ann Smith, FNP
• Lyndy Mae Smith
• Mary Therese Smith, MFT
• Maxwell Edison Smith, PT, DPT
• Mealani Marie Smith, ASCW
• Orion Smith
• Rachel Janeane Smith
• Robert J Smith, P.A.
• Ryan Alexander Smith, M.D.
• Steve Smith, PHARMD

• Pediatric Nurse Practitioner in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.