Nicole Irene Back

Key facts

NPI

1013756576

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

4704247636 (MI)

Practice address

5758 Cooley Lake Rd
Waterford, MI 48327-3073

Phone

(855) 466-3631

NPI assigned

May 23, 2024

Sex

Female

Sole proprietor

No

Organizations & group practices 17

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.

• Clinton Urgent Care Walk-in Clinic Family Medicine Physician · Clinton Township, MI · NPI 1831610070
  Medicare reassignment Care Compare group NPD MI
• Transitional Care Services, LLC Gerontology Nurse Practitioner · Waterford, MI · NPI 1174976807
  Medicare reassignment Care Compare group NPD GERONTOLOGY · MI
• Best Urgent Care PC Urgent Care Clinic/Center · Redford, MI · NPI 1952791105
  Medicare reassignment NPD MI
• Canton Urgent Care Walk-in Clinic PC Urgent Care Clinic/Center · Canton, MI · NPI 1649712480
  Medicare reassignment NPD MI
• Chesterfield Urgent Care Walk-in Clinic Urgent Care Clinic/Center · Chesterfield, MI · NPI 1629547195
  Medicare reassignment NPD MI
• Commerce Urgent Care Walk-in Clinic Urgent Care Clinic/Center · Commerce TWP, MI · NPI 1952823825
  Medicare reassignment NPD MI
• Doctors Urgent Care Livonia PC Urgent Care Clinic/Center · Livonia, MI · NPI 1922983048
  Medicare reassignment NPD MI
• Doctors Urgent Care Sterling Heights West Urgent Care Clinic/Center · Sterling Heights, MI · NPI 1992464697
  Medicare reassignment NPD MI
• Doctors Urgent Care Troy West PC Urgent Care Clinic/Center · Troy, MI · NPI 1790428423
  Medicare reassignment NPD MI
• Farmington Hills Urgent Care Walk-in Clinic PC Urgent Care Clinic/Center · Farmington Hills, MI · NPI 1144956350
  Medicare reassignment NPD MI
• Rochester Urgent Care Walk-in Clinic Urgent Care Clinic/Center · Rochester Hills, MI · NPI 1225554694
  Medicare reassignment NPD MI
• Shelby Urgent Care Walk-in Clinic Family Medicine Physician · Shelby TWP, MI · NPI 1285155119
  Medicare reassignment NPD MI
• Sterling Heights Urgent Care Walk-in Clinic Urgent Care Clinic/Center · Sterling Heights, MI · NPI 1912413949
  Medicare reassignment NPD MI
• Taylor Urgent Care PC Urgent Care Clinic/Center · Taylor, MI · NPI 1013321033
  Medicare reassignment NPD MI
• Troy Urgent Care Walk-in Clinic Urgent Care Clinic/Center · Troy, MI · NPI 1720571227
  Medicare reassignment NPD MI
• Ypsilanti Urgent Care Walk-in Clinic Urgent Care Clinic/Center · Ypsilanti, MI · NPI 1881048494
  Medicare reassignment NPD MI
• Doctors Urgent Care Southfield Urgent Care Clinic/Center · Southfield, MI · NPI 1326660929
  NPD (past)

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• A Choice Home Health Care, Inc. Home Health Agency · Troy, MI · NPI 1124154240
  Care Compare affiliation Home health agency
• Beaumont Ashn, LLC Home Health Agency · Troy, MI · NPI 1811461734
  Care Compare affiliation Home health agency
• Residential Home Health, LLC Home Health Agency · Troy, MI · NPI 1992768550
  Care Compare affiliation Home health agency
• Safe Hands Home Health Care, LLC Home Health Agency · Farmington Hills, MI · NPI 1992963326
  Care Compare affiliation Home health agency
• T.O.N.E. Home Health Services, Inc. Home Health Agency · Farmington Hills, MI · NPI 1861420879
  Care Compare affiliation Home health agency
• William Beaumont Hospital General Acute Care Hospital · Troy, MI · NPI 1306825997
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Clinton Urgent Care Walk in Clinic (2 clinicians)
Transitional Care Services LLC (45 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• A Choice Home Health Care, Inc. Home health agency · Troy, MI · CCN 237747
• Beaumont Home Health Home health agency · Troy, MI · CCN 237112
• Tone Home Health Services Home health agency · Farmington Hills, MI · CCN 237634
• Residential Home Health Home health agency · Troy, MI · CCN 237459
• Safe Hands Home Health Care Home health agency · Farmington Hills, MI · CCN 239025
• Beaumont Hospital, Troy Hospital · Troy, MI · CCN 230269

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicole.back.1@31855.direct.athenahealth.com

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 6, 2025.

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1013756576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5758 COOLEY LAKE RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483273073",
            "telephone_number": "855-466-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5758 COOLEY LAKE RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483273073",
            "telephone_number": "855-466-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACK",
        "first_name": "NICOLE",
        "middle_name": "IRENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-23",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704247636",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704247636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Waterford, MI · Family Nurse Practitioner in Michigan