Active NPI
Michelle Nelson
- Peer Specialist
- Devils Lake, ND
National Provider Identifier
1043071574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 441
- Practice address
- 200 Highway 2 W
Devils Lake, ND 58301-3532 - Phone
- (701) 520-1312
- NPI assigned
- Jan 22, 2024
- Last updated
- Jan 22, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 441 | ND | Primary |
Addresses
Primary practice location
200 Highway 2 W
Devils Lake, ND 58301-3532
Mailing address
200 Highway 2 W
Devils Lake, ND 58301-3532
Phone (701) 520-1312
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 |
|---|---|---|---|
| 441 | ND | MD | Corneal and Contact Management Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705881600000",
"number": "1043071574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 HIGHWAY 2 W",
"city": "DEVILS LAKE",
"state": "ND",
"postal_code": "583013532",
"telephone_number": "701-520-1312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 HIGHWAY 2 W",
"city": "DEVILS LAKE",
"state": "ND",
"postal_code": "583013532",
"telephone_number": "701-520-1312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "MICHELLE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-22",
"last_updated": "2024-01-22",
"certification_date": "2024-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "ND",
"license": "441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Devils Lake, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.