Individual provider Active NPI

Michelle Guillot

  • Family Nurse Practitioner
  • Austin, TX
National Provider Identifier
1124783428
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1058052 Issued in TX
Practice address
1108 Lavaca St Ste 110-320
Austin, TX 78701-2172
Phone
(512) 477-4088
Fax
(512) 482-0390
NPI assigned
Nov 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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 1058052 TX Primary

Addresses

Primary practice location

1108 Lavaca St Ste 110-320
Austin, TX 78701-2172

Mailing address

2501 La Rochelle Dr
Cedar Park, TX 78613-4720
Phone (512) 983-1341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211130001223 TX Practitioner - Nurse Practitioner 5799175063 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1058052TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Texas Palliative Care Associates CurrentSince Aug 29, 2022 Accepting new patients
Austin Geriatric Specialists, PLLC CurrentSince Nov 1, 2021 Accepting new patients
Hni Medical Services PastSince Nov 1, 2021 Accepting new patients
Hospice Austin PastSince Aug 29, 2022 Accepting new patients

Locations

1108 Lavaca St
Ste 110320
Austin, TX 78701
Phone (512) 482-0390

11406 Rustic Rock Dr
Austin, TX 78750
Phone (512) 251-3915

4107 Spicewood Springs Rd
Ste 100
Austin, TX 78759
Phone (512) 342-4700

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18292/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/25850/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1635811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1124783428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 LA ROCHELLE DR",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786134720",
            "telephone_number": "512-983-1341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 LAVACA ST STE 110-320",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787012172",
            "telephone_number": "512-477-4088",
            "fax_number": "512-482-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLOT",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-02",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1058052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.