Active NPI
Michele R Profeta, RNFA
- Registered Nurse
- Aberdeen, SD
National Provider Identifier
1164097234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R022496
- Practice address
- 2905 3Rd Ave SE
Aberdeen, SD 57401-5420 - Phone
- (605) 626-4600
- NPI assigned
- May 21, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R022496 | SD | Primary |
Addresses
Primary practice location
2905 3Rd Ave SE
Aberdeen, SD 57401-5420
Mailing address
2905 3Rd Ave SE
Aberdeen, SD 57401-5420
Phone (605) 626-4600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R022496 | Other | SD | STATE NURSING 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
| License | State | Type | Specialty |
|---|---|---|---|
| R022496 | SD | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621555200000",
"number": "1164097234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2905 3RD AVE SE",
"city": "ABERDEEN",
"state": "SD",
"postal_code": "574015420",
"telephone_number": "605-626-4600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2905 3RD AVE SE",
"city": "ABERDEEN",
"state": "SD",
"postal_code": "574015420",
"telephone_number": "605-626-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROFETA",
"first_name": "MICHELE",
"middle_name": "R",
"name_prefix": "Mrs.",
"credential": "RNFA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-21",
"last_updated": "2021-05-21",
"certification_date": "2021-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "SD",
"license": "R022496",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE NURSING LICENSE",
"identifier": "R022496",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aberdeen, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.