Individual provider Active NPI

Michelle Pownall, APRN

  • Nurse Practitioner
  • Melbourne, FL
National Provider Identifier
1255615712
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN3168612 Issued in FL
Practice address
930 S Harbor City Blvd Ste 100
Melbourne, FL 32901-1901
Phone
(321) 345-7579
Fax
(833) 944-2173
NPI assigned
Oct 3, 2011
Last updated
Apr 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN3168612 FL Primary

Addresses

Primary practice location

930 S Harbor City Blvd Ste 100
Melbourne, FL 32901-1901

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (321) 345-7579

Other practice location 1

3830 S Highway A1A Ste C5
Melbourne, FL 32951-3145
Phone (321) 345-7579

Other identifiers 5

IdentifierTypeStateIssuer
FS034WOtherFLMEDICARE
9592477OtherFLAETNA
P01165560OtherFLRR MEDICARE GROUP DT5990
Y09HXOtherFLFLORIDA BLUE
O3902OtherFLMEDICARE HF

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120119000791 FL Practitioner - Nurse Practitioner 5890962534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RHMD LLCGroup PAC ID 2769865963, 2 clinicians

Practice addresses (Care Compare)

417 5TH Ave
Apt 101
Indialantic, FL 32903-4224
Phone (321) 615-6569

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
RHMD LLC CurrentSince Oct 1, 2023 Accepting new patients

Locations

417 5th Ave
Apt 101
Indialantic, FL 32903
Phone (305) 304-7842

Interoperability endpoints

  • Direct secure messaging: michelle.pownall@qmc.directbygreenway.com

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1255615712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "321-345-7579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 S HARBOR CITY BLVD STE 100",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011901",
            "telephone_number": "321-345-7579",
            "fax_number": "833-944-2173"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3830 S Highway A1A Ste C5",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329513145",
            "country_code": "US",
            "telephone_number": "321-345-7579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POWNALL",
        "first_name": "MICHELLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-03",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN3168612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "FS034W",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9592477",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP DT5990",
            "identifier": "P01165560",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "Y09HX",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE HF",
            "identifier": "O3902",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.