Active NPI
Michelle S Page, MD
- Pediatrics Physician
- Pace, FL
National Provider Identifier
1053369991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME77356
- Practice address
- 4288 Woodbine Rd
Suite D
Pace, FL 32571-8795 - Phone
- (850) 995-8600
- Fax
- (850) 995-9060
- NPI assigned
- May 4, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME77356 | FL | Primary |
Addresses
Primary practice location
4288 Woodbine Rd
Suite D
Pace, FL 32571-8795
Mailing address
4288 Woodbine Rd
Suite D
Pace, FL 32571-8782
Phone (850) 995-8600
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35565 | Other | FL | BLUE CROSS & BLUE SHIELD |
| 259249500 | Medicaid | FL | |
| 591-84273 | Other | AL | BLUE CROSS & BLUE SHIELD |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME77356 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michelle S Page MD PA | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Pace, FL
- NPI 1407018138
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321920000000",
"number": "1053369991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4288 WOODBINE RD",
"address_2": "SUITE D",
"city": "PACE",
"state": "FL",
"postal_code": "325718782",
"telephone_number": "850-995-8600",
"fax_number": "850-995-9060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4288 WOODBINE RD",
"address_2": "SUITE D",
"city": "PACE",
"state": "FL",
"postal_code": "325718795",
"telephone_number": "850-995-8600",
"fax_number": "850-995-9060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAGE",
"first_name": "MICHELLE",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-04",
"last_updated": "2011-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME77356",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS & BLUE SHIELD",
"identifier": "35565",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "259249500",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS & BLUE SHIELD",
"identifier": "591-84273",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pace, FL
- Pace Obstetrics and Gynecology
- Pace Pastoral Counseling Center
- Pace Pharmacy, LLC
- Pace Surgery Center
- Pace Surgery Center
- Sibyl Tenille Page, APRN
- Pamela Ann Schurman DO PA
- Devon Ciara Parsch, MSW
- Partners Family Medicine Practice & Recovery Center Inc
- Partners Family Medicine Practice and Addiction Recovery Center Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.