Individual provider Active NPI

Bianca Noel Nolta

  • Psychiatric/Mental Health Nurse Practitioner
  • Jackson, MI
National Provider Identifier
1235006248
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704318922NSA2606R Issued in MI
Practice address
1200 N West Ave
Jackson, MI 49202-2179
Phone
(800) 284-8288
NPI assigned
Oct 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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 4704318922 MI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704318922NSA2606R MI Primary

Addresses

Primary practice location

1200 N West Ave
Jackson, MI 49202-2179

Mailing address

48245 Manhattan Cir
Canton, MI 48188-1498
Phone (734) 756-1133

Other practice location 1

5301 McAuley Dr
Ypsilanti, MI 48197-1051
Phone (734) 712-3456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20260430000782 MI Practitioner - Nurse Practitioner 9537636295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jackson-Hillsdale Community Mental Health BoardGroup PAC ID 6406808062, 27 clinicians

Practice addresses (Care Compare)

1200 N W Ave
Jackson, MI 49202-2179
Phone (517) 789-1200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704318922MIMDRegistered Nurse
4704318922NSA2606RMIMDPsychiatric/Mental Health Nurse Practitioner

Organizations & group practices 1

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": "1761091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1235006248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48245 MANHATTAN CIR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481881498",
            "telephone_number": "734-756-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N WEST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022179",
            "telephone_number": "800-284-8288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5301 McAuley Dr",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "481971051",
            "country_code": "US",
            "telephone_number": "734-712-3456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOLTA",
        "first_name": "BIANCA",
        "middle_name": "NOEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-22",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704318922",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704318922NSA2606R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.