Active NPI
Michael Scott Nystul, PH.D
- Psychologist
- Las Cruces, NM
National Provider Identifier
1023140530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 446
- Practice address
- 1395 Missouri Ave
Las Cruces, NM 88001-5327 - Phone
- (575) 522-5466
- NPI assigned
- Mar 10, 2007
- Last updated
- Oct 15, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 446 | NM | Primary |
Addresses
Primary practice location
1395 Missouri Ave
Las Cruces, NM 88001-5327
Mailing address
4310 Summit LN
Las Cruces, NM 88011-7552
Phone (575) 993-3586
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 446 | NM | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413331200000",
"number": "1023140530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4310 SUMMIT LN",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880117552",
"telephone_number": "575-993-3586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1395 MISSOURI AVE",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880015327",
"telephone_number": "575-522-5466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NYSTUL",
"first_name": "MICHAEL",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-10",
"last_updated": "2014-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NM",
"license": "446",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.