Active NPI
Kim Michelli
- Registered Nurse
- Coram, NY
National Provider Identifier
1033431051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 281474-1
- Practice address
- 2 Monitor CT
Coram, NY 11727-1634 - Phone
- (631) 642-7493
- NPI assigned
- Feb 17, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 281474-1 | NY | Primary |
| Home Health Registered Nurse | 163WH0200X | 281474-1 | NY |
Addresses
Primary practice location
2 Monitor CT
Coram, NY 11727-1634
Mailing address
2 Monitor Court
Coram, NY 11720
Phone (631) 642-7493
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 281474-1 | Other | NY | RN LICENSCE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 281474-1 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266364800000",
"number": "1033431051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 MONITOR COURT",
"city": "CORAM",
"state": "NY",
"postal_code": "11720",
"telephone_number": "631-642-7493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 MONITOR CT",
"city": "CORAM",
"state": "NY",
"postal_code": "117271634",
"telephone_number": "631-642-7493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHELLI",
"first_name": "KIM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-17",
"last_updated": "2010-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "281474-1",
"primary": true
},
{
"code": "163WH0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Home Health",
"state": "NY",
"license": "281474-1",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICENSCE",
"identifier": "281474-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coram, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.