Individual provider Active NPI

Michelle Villalba, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Akron, OH
National Provider Identifier
1184240202
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0027083 Issued in OH
Practice address
150 Cross Street
Akron, OH 44311-1026
Phone
(330) 253-9388
Fax
(330) 376-6726
NPI assigned
Jun 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.275080 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0027083 OH Primary

Addresses

Primary practice location

150 Cross Street
Akron, OH 44311-1026

Mailing address

150 Cross Street
Akron, OH 44311-1026
Phone (330) 253-9388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20200924000412 OH Practitioner - Nurse Practitioner 7214356294 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.275080OHMDRegistered Nurse
APRN.CNP.0027083OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Support Services Inc CurrentSince Aug 31, 2020 Accepting new patients
Community Support Services, Inc CurrentSince Aug 31, 2020 Accepting new patients

Locations

150 Cross St
Akron, OH 44311
Phone (330) 253-9388

Organizations & group practices 2

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": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1184240202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 CROSS STREET",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443111026",
            "telephone_number": "330-253-9388",
            "fax_number": "330-376-6726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 CROSS STREET",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443111026",
            "telephone_number": "330-253-9388",
            "fax_number": "330-376-6726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLALBA",
        "first_name": "MICHELLE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-24",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.275080",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0027083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.