Individual provider Active NPI

Michelle Marie Knapp, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Venice, FL
National Provider Identifier
1104267061
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
401622 Issued in NY
Practice address
611 Missouri Rd
Venice, FL 34293-6447
Phone
(216) 536-6212
NPI assigned
Jul 8, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 401622 NY Primary

Addresses

Primary practice location

611 Missouri Rd
Venice, FL 34293-6447

Mailing address

1307 Guardian Dr
Venice, FL 34292-1626
Phone (216) 536-6212

Other practice location 1

1307 Guardian Dr
Venice, FL 34292-1626
Phone (216) 536-6212

Other practice location 2

2929 W 31st St Apt 10L4
Brooklyn, NY 11224-1721
Phone (216) 536-6212

Other practice location 3

1531 Tamiami Trl S
Venice, FL 34285-5570
Phone (216) 536-6212

Other identifiers 1

IdentifierTypeStateIssuer
04131288MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address michelle@wholisticpsychiatry.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
401622NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wholistic Psychiatry PLLC Psychiatric/Mental Health CurrentSince Jul 17, 2022 Accepting new patients

Locations

1531 Tamiami Trl S
Ste 703
Venice, FL 34285
Phone (941) 451-1122

1531 Tamiami Trl S
Venice, FL 34285
Phone (216) 536-6212

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.

NPI Registry JSON

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1104267061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 GUARDIAN DR",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342921626",
            "telephone_number": "216-536-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 MISSOURI RD",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342936447",
            "telephone_number": "216-536-6212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1307 Guardian Dr",
            "address_purpose": "LOCATION",
            "city": "Venice",
            "state": "FL",
            "postal_code": "342921626",
            "country_code": "US",
            "telephone_number": "216-536-6212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2929 W 31st St Apt 10L4",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112241721",
            "country_code": "US",
            "telephone_number": "216-536-6212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1531 Tamiami Trl S",
            "address_purpose": "LOCATION",
            "city": "Venice",
            "state": "FL",
            "postal_code": "342855570",
            "country_code": "US",
            "telephone_number": "216-536-6212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNAPP",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-08",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "401622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04131288",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michelle@wholisticpsychiatry.com",
            "affiliation": "N",
            "endpointDescription": "safe and secure email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "safe and secure email",
            "address_1": "611 Missouri Rd",
            "city": "Venice",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342936447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

Verify at the official NPI Registry.