Individual provider Active NPI

Michelle Alyson Simmonds Nelson, PHD, RN, MS, FNP-BC

  • Family Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1104062082
Registry record updated May 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F333283 Issued in NY
Practice address
256C Mason Ave
Staten Island, NY 10305-3408
Phone
(718) 226-6231
Fax
(718) 226-6164
NPI assigned
Dec 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F333283 NY Primary

Addresses

Primary practice location

256C Mason Ave
Staten Island, NY 10305-3408

Mailing address

256C Mason Ave
Staten Island, NY 10305-3408
Phone (718) 226-6231

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
Master of Science, Doctor of Philosophy, Registered Nurse

State licenses

LicenseStateTypeSpecialty
F333283NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1230249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464220800000",
    "number": "1104062082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256C MASON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053408",
            "telephone_number": "718-226-6231",
            "fax_number": "718-226-6164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256C MASON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053408",
            "telephone_number": "718-226-6231",
            "fax_number": "718-226-6164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONDS NELSON",
        "first_name": "MICHELLE",
        "middle_name": "ALYSON",
        "name_prefix": "Ms.",
        "credential": "PHD, RN, MS, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-26",
        "last_updated": "2016-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F333283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; 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.