Individual provider Active NPI

Michelle Audrey Humann

  • Speech-Language Pathologist
  • Bayside, NY
National Provider Identifier
1013210954
Registry record updated Dec 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
020670 Issued in NY
Practice address
3224 Corporal Kennedy St
Bayside, NY 11361-1061
Phone
(718) 229-7600
NPI assigned
Dec 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 020670 NY Primary

Addresses

Primary practice location

3224 Corporal Kennedy St
Bayside, NY 11361-1061

Mailing address

3224 Corporal Kennedy St
Bayside, NY 11361-1061
Phone (718) 229-7600

Other names 1

  • Michelle Audrey Mirro Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481068800000",
    "number": "1013210954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3224 CORPORAL KENNEDY ST",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113611061",
            "telephone_number": "718-229-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3224 CORPORAL KENNEDY ST",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113611061",
            "telephone_number": "718-229-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMANN",
        "first_name": "MICHELLE",
        "middle_name": "AUDREY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-15",
        "last_updated": "2016-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "020670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "MIRRO",
            "middle_name": "AUDREY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; 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.