Michelle Aubrie Feneck, RN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26728 Issued in TN

Practice address

2788 Murfreesboro Pike
Antioch, TN 37013-2004

Phone

(714) 329-7594

NPI assigned

Nov 5, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1352073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1194079764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2788 MURFREESBORO PIKE",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370132004",
            "telephone_number": "714-329-7594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2788 MURFREESBORO PIKE",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370132004",
            "telephone_number": "714-329-7594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENECK",
        "first_name": "MICHELLE",
        "middle_name": "AUBRIE",
        "credential": "RN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-05",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "26728",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "822120",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "33-0150193",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Antioch, TN
• Providers in Antioch, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.