Individual provider Active NPI

Michella Harrell

  • Prosthetics Case Management
  • San Diego, CA
National Provider Identifier
1114582202
Registry record updated May 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
License
KK574589 Issued in CA
Practice address
8690 Aero Dr Ste 104
San Diego, CA 92123-1759
Phone
(858) 278-4566
NPI assigned
May 5, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case ManagementGroup: 193400000X SINGLE SPECIALTY GROUP 1744P3200X KK574589 CA Primary

Addresses

Primary practice location

8690 Aero Dr Ste 104
San Diego, CA 92123-1759

Mailing address

3462 Lockwood Dr
San Diego, CA 92123-2620

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
KK574589CAMDProsthetics Case Management

NPI Registry JSON

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

{
    "created_epoch": "1557014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557014400000",
    "number": "1114582202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3462 LOCKWOOD DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8690 AERO DR STE 104",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231759",
            "telephone_number": "858-278-4566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRELL",
        "first_name": "MICHELLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-05",
        "last_updated": "2019-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "CA",
            "license": "KK574589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2019; 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.