Nicole Irene Back

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704247636 Issued in MI

Practice address

5758 Cooley Lake Rd
Waterford, MI 48327-3073

Phone

(855) 466-3631

NPI assigned

May 23, 2024

Last updated

Mar 6, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

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 ClinicGroup PAC ID 7719257625, 2 clinicians

Transitional Care Services LLCGroup PAC ID 6709165954, 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 enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clinton Urgent Care Walk-in Clinic

  • Family Medicine Physician
  • Clinton Township, MI
  • NPI 1831610070
  Medicare reassignment Care Compare group NPD
• Transitional Care Services, LLC

  dba HomeMD Housecall Services

  • Gerontology Nurse Practitioner
  • Waterford, MI
  • NPI 1174976807
  Medicare reassignment Care Compare group NPD
• Best Urgent Care PC

  • Urgent Care Clinic/Center
  • Redford, MI
  • NPI 1952791105
  Medicare reassignment NPD
• Canton Urgent Care Walk-in Clinic PC

  • Urgent Care Clinic/Center
  • Canton, MI
  • NPI 1649712480
  Medicare reassignment NPD
• Chesterfield Urgent Care Walk-in Clinic

  • Urgent Care Clinic/Center
  • Chesterfield, MI
  • NPI 1629547195
  Medicare reassignment NPD
• Commerce Urgent Care Walk-in Clinic

  • Urgent Care Clinic/Center
  • Commerce TWP, MI
  • NPI 1952823825
  Medicare reassignment NPD
• Doctors Urgent Care Livonia PC

  • Urgent Care Clinic/Center
  • Livonia, MI
  • NPI 1922983048
  Medicare reassignment NPD
• Doctors Urgent Care Sterling Heights West

  • Urgent Care Clinic/Center
  • Sterling Heights, MI
  • NPI 1992464697
  Medicare reassignment NPD
• Doctors Urgent Care Troy West PC

  • Urgent Care Clinic/Center
  • Troy, MI
  • NPI 1790428423
  Medicare reassignment NPD
• Farmington Hills Urgent Care Walk-in Clinic PC

  • Urgent Care Clinic/Center
  • Farmington Hills, MI
  • NPI 1144956350
  Medicare reassignment NPD
• Rochester Urgent Care Walk-in Clinic

  • Urgent Care Clinic/Center
  • Rochester Hills, MI
  • NPI 1225554694
  Medicare reassignment NPD
• Shelby Urgent Care Walk-in Clinic

  • Family Medicine Physician
  • Shelby TWP, MI
  • NPI 1285155119
  Medicare reassignment NPD

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
• Beaumont Ashn, LLC

  dba Beaumont Home Health and Hospice, LLC

  • Home Health Agency
  • Troy, MI
  • NPI 1811461734
  Care Compare affiliation
• Residential Home Health, LLC

  • Home Health Agency
  • Troy, MI
  • NPI 1992768550
  Care Compare affiliation
• Safe Hands Home Health Care, LLC

  • Home Health Agency
  • Farmington Hills, MI
  • NPI 1992963326
  Care Compare affiliation
• T.O.N.E. Home Health Services, Inc.

  • Home Health Agency
  • Farmington Hills, MI
  • NPI 1861420879
  Care Compare affiliation
• William Beaumont Hospital

  dba Beaumont Hospital, Troy

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation

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

{
    "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": []
}

• Elizabeth Ayres
• Jeffrey Richard Ayres, CAC1
• B.D.G.Optics, Inc
• Cassandra Babcock
• Roberta Stefanie Babics, LLBSW
• Kelly Backers
• M-Amin Badawi, M.D.
• Mirza Asif Baig, MD
• Janice Rataj Baker, LLMSW
• Nykol Baker

• Family Nurse Practitioner in Waterford, MI
• Providers in Waterford, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.