Individual provider Active NPI

Michele Hallowell Beckerman, ARNP

  • Ambulatory Women's Health Care Registered Nurse
  • St Petersburg, FL
National Provider Identifier
1083988398
Registry record updated Mar 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Women's Health Care Registered NurseTaxonomy code 163WW0101X
License
1697052 Issued in FL
Practice address
205 Dr Martin Luther King St N
St Petersburg, FL 33701-3109
Phone
(727) 824-6900
NPI assigned
Mar 5, 2012
Last updated
Mar 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Women's Health Care Registered Nurse 163WW0101X 1697052 FL Primary

Addresses

Primary practice location

205 Dr Martin Luther King St N
St Petersburg, FL 33701-3109

Mailing address

9260 142ND St
Seminole, FL 33776-2005
Phone (727) 433-1824

Other identifiers 1

IdentifierTypeStateIssuer
1697052OtherFLSTATE OF FLORIDA ARNP LICENSE

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

LicenseStateTypeSpecialty
1697052FLMDAmbulatory Women's Health Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330905600000",
    "number": "1083988398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9260 142ND ST",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337762005",
            "telephone_number": "727-433-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 DR MARTIN LUTHER KING ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013109",
            "telephone_number": "727-824-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKERMAN",
        "first_name": "MICHELE",
        "middle_name": "HALLOWELL",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-05",
        "last_updated": "2012-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "FL",
            "license": "1697052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF FLORIDA ARNP LICENSE",
            "identifier": "1697052",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.