MRS. MELISSA DE ANN GILLISPIE, RN - NPI NUMBER 1538214267

Summary

Provider Name: MRS. MELISSA DE ANN GILLISPIE, RN

NPI Number: 1538214267

Clasification: Registered Nurse (163W00000X)

Address:
512 S PRAIRIE AVE
PUEBLO, CO
ZIP 81005

Phone Number: (719) 542-3218



Detailed Information

MRS. Melissa De Ann Gillispie, RN is a registered nurse in Pueblo, CO. The provider is (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.�s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span. The assigned NPI number for this provider is 1538214267 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business address is:

512 S PRAIRIE AVE
PUEBLO, CO
ZIP 81005-724
Phone: (719) 542-3218

The enumeration date for this NPI number is 1/24/2007 and was last updated on 8/14/2007.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 163W00000X Registered Nurse 109079 CO Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 07090798 MEDICAID CO

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1538214267 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name GILLISPIE The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name MELISSA The first name of the provider, if the provider is an individual.
5 Provider Middle Name DE ANN The middle name of the provider, if the provider is an individual.
6 Provider Name Prefix Text MRS. The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
7 Provider Credential Text RN The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
8 Provider First Line Business Practice Location Address 512 S PRAIRIE AVE The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
9 Provider Business Practice Location Address City Name PUEBLO The city name in the location address of the provider being identified.
10 Provider Business Practice Location Address State Name CO The State code in the location of the provider being identified.
11 Provider Business Practice Location Address Postal Code 810051724 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
12 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
13 Provider Business Practice Location Address Telephone Number 7195423218 The telephone number associated with the location address of the provider being identified.
14 Provider Enumeration Date 1/24/2007 The date the provider was assigned a unique identifier (assigned an NPI).
15 Last Update Date 8/14/2007 The date that a record was last updated or changed.
16 Provider Gender Code F The code designating the provider’s gender if the provider is a person.
17 Healthcare Provider Taxonomy Code 1 163W00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
18 Provider License Number 1 109079 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
19 Provider License Number State Code 1 CO The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Other Provider Identifier 1 07090798 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
22 Other Provider Identifier Type Code 1 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
23 Other Provider Identifier State 1 CO
24 Is Sole Proprietor N Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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