Individual provider Active NPI

Michelle Gillenwater, RN

  • Medical-Surgical Registered Nurse
  • New Rochelle, NY
National Provider Identifier
1003051962
Registry record updated Dec 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
502394 Issued in NY
Practice address
26 Albermarle Ave
New Rochelle, NY 10801-2001
Phone
(941) 576-3584
NPI assigned
Dec 8, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 502394 NY Primary
School Registered Nurse 163WS0200X 502394 NY

Addresses

Primary practice location

26 Albermarle Ave
New Rochelle, NY 10801-2001

Mailing address

26 Albermarle Ave
New Rochelle, NY 10801-2001
Phone (941) 576-3584

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
502394NYMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1228694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228694400000",
    "number": "1003051962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 ALBERMARLE AVE",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108012001",
            "telephone_number": "941-576-3584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 ALBERMARLE AVE",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108012001",
            "telephone_number": "941-576-3584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLENWATER",
        "first_name": "MICHELLE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-08",
        "last_updated": "2008-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NY",
            "license": "502394",
            "primary": true
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "502394",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2008; 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.