Individual provider Active NPI

Antiniece Nicole McPhearson

  • Nurse's Aide
  • Kalamazoo, MI
National Provider Identifier
1184339533
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
Practice address
719 Butterfly Apt 259
Kalamazoo, MI 49009-3217
Phone
(314) 728-0474
NPI assigned
Jan 19, 2023
Last updated
Jun 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X NU Primary
Nurse's Aide 376K00000X 141824 MO
Licensed Practical Nurse 164W00000X 2021036978 MO

Addresses

Primary practice location

719 Butterfly Apt 259
Kalamazoo, MI 49009-3217

Mailing address

4056 Finney Ave
Saint Louis, MO 63113-3426
Phone (314) 728-0474

Other practice location 1

505 E Kalamazoo Ave Ste A
Kalamazoo, MI 49007-3873
Phone (314) 728-0474

Other practice location 2

505 E Kalamazoo Ave
Kalamazoo, MI 49007-3873

Other practice location 3

505 E Kalamazoo Ave Ste A
Kalamazoo, MI 49007-3873

Other practice location 4

505 E Kalamazoo Ave Ste A
Kalamazoo, MI 49007-3873

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
2021036978MOMDLicensed Practical Nurse
141824MOMDNurse's Aide

Practice roles

OrganizationSpecialtyStatusNew patients
Trust US Home Care LLC CurrentSince Jan 22, 2023 Accepting new patients
Extended Hearts Homecare LLC CurrentSince May 1, 2023 Accepting new patients

Locations

505 E Kalamazoo Ave
Ste A
Kalamazoo, MI 49007
Phone (314) 728-0474

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1674086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1184339533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4056 FINNEY AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631133426",
            "telephone_number": "314-728-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 BUTTERFLY APT 259",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490093217",
            "telephone_number": "314-728-0474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 E Kalamazoo Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490073873",
            "country_code": "US",
            "telephone_number": "314-728-0474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "505 E Kalamazoo Ave",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490073873",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "505 E Kalamazoo Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490073873",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "505 E Kalamazoo Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490073873",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCPHEARSON",
        "first_name": "ANTINIECE",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-19",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "MO",
            "license": "141824",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MO",
            "license": "2021036978",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; 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.