Active NPI
Pamela S Micko
- Behavior Analyst
- Alma, MI
National Provider Identifier
1295352219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 623 W Warwick Dr Ste 2
Alma, MI 48801-1177 - Phone
- (989) 285-1490
- NPI assigned
- Jun 26, 2020
- Last updated
- Jun 26, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | NU | Primary |
Addresses
Primary practice location
623 W Warwick Dr Ste 2
Alma, MI 48801-1177
Mailing address
623 W Warwick Dr Ste 2
Alma, MI 48801-1177
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| M200676778346 | Medicaid | MI |
Electronic endpoints 6
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Catalyst | ||
| CONNECT URL | Catalyst | ||
| CONNECT URL | Catalyst | ||
| CONNECT URL | Catalyst | ||
| CONNECT URL | Catalyst | ||
| CONNECT URL | Catalyst |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Plus Health Services | Behavior Analyst | Current | Accepting new patients |
| Mercy Plus | Current | Accepting new patients |
Locations
623 W Warwick Dr
Ste 2
Alma, MI 48801
Phone (989) 285-1490
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Alma, MI
- NPI 1902481658
-
- Behavior Analyst
- Alma, MI
- NPI 1447851233
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593129600000",
"number": "1295352219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "623 W WARWICK DR STE 2",
"city": "ALMA",
"state": "MI",
"postal_code": "488011177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "623 W WARWICK DR STE 2",
"city": "ALMA",
"state": "MI",
"postal_code": "488011177",
"telephone_number": "989-285-1490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICKO",
"first_name": "PAMELA",
"middle_name": "S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-26",
"last_updated": "2020-06-26",
"certification_date": "2020-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "M200676778346",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Catalyst",
"affiliation": "N",
"address_1": "623 W Warwick Dr Ste 2",
"city": "Alma",
"state": "MI",
"country_code": "US",
"postal_code": "488011177",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Catalyst",
"affiliation": "N",
"address_1": "623 W Warwick Dr Ste 2",
"city": "Alma",
"state": "MI",
"country_code": "US",
"postal_code": "488011177",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Catalyst",
"affiliation": "N",
"address_1": "623 W Warwick Dr Ste 2",
"city": "Alma",
"state": "MI",
"country_code": "US",
"postal_code": "488011177",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Catalyst",
"affiliation": "N",
"address_1": "623 W Warwick Dr Ste 2",
"city": "Alma",
"state": "MI",
"country_code": "US",
"postal_code": "488011177",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Catalyst",
"affiliation": "N",
"address_1": "623 W Warwick Dr Ste 2",
"city": "Alma",
"state": "MI",
"country_code": "US",
"postal_code": "488011177",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Catalyst",
"affiliation": "N",
"address_1": "623 W Warwick Dr Ste 2",
"city": "Alma",
"state": "MI",
"country_code": "US",
"postal_code": "488011177",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Alma, MI
- Michigan Masonic Home (Masonic Pathways)
- Michigan Masonic Home (Warwick Living Center)
- Michigan Masonic Home (Masonic Pathways)
- Michigan Masonic Home (Masonic Pathways)
- Michigan Radiation Medicine PLLC
- Mid Michigan Ketamine Clinic PLLC
- Mid-Michigan Health Care Associates,LTD (Warwick Living Center)
- Mid-Michigan Radiology Associates, PC
- Midmichigan Home Health Services (Gratiot Home Medical)
- Midmichigan Visiting Nurse Association (MidMichigan Home Care)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.