NPIMap

Individual provider Active NPI

Michelle A Richmond, AG-PCNP

  • Gerontology Nurse Practitioner
  • Waterloo, IA
National Provider Identifier
1306470851
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AG02200055 Issued in IA
Practice address
1440 W Dunkerton Rd
Waterloo, IA 50703-9648
Phone
(319) 291-2455
Fax
(319) 291-2464
NPI assigned
Feb 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AG02200055 IA Primary

Addresses

Primary practice location

1440 W Dunkerton Rd
Waterloo, IA 50703-9648

Mailing address

1440 W Dunkerton Rd
Waterloo, IA 50703-9648
Phone (319) 291-2455

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL NIJDS.ORG

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200604002491 IA Practitioner - Nurse Practitioner 6204257991 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1825 Logan Ave
Waterloo, IA 50703-1916
Phone (319) 235-3941

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AG02200055IAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation CurrentSince May 18, 2020 Accepting new patients
Salahuddin Syed MD PC Current Accepting new patients
Unitypoint Health - Marshalltown CurrentSince Dec 6, 2021 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Unitypoint Health - Marshalltown CurrentSince Dec 6, 2021 Accepting new patients

Locations

1795 Highway 64 E
Anamosa, IA 52205
Phone (319) 462-3131

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

201 E J Ave
Grundy Center, IA 50638
Phone (319) 824-5081

101 E J Ave
Ste 120
Grundy Center, IA 50638
Phone (319) 824-6945

55 Unitypoint Way
Marshalltown, IA 50158
Phone (641) 754-5145

1825 Logan Ave
Waterloo, IA 50703
Phone (319) 235-3886

Interoperability endpoints

  • Direct secure messaging: mrichmond150178@direct.unitypoint.org

Organizations & group practices 5

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 8

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": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1306470851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 W DUNKERTON RD",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507039648",
            "telephone_number": "319-291-2455",
            "fax_number": "319-291-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 W DUNKERTON RD",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507039648",
            "telephone_number": "319-291-2455",
            "fax_number": "319-291-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHMOND",
        "first_name": "MICHELLE",
        "middle_name": "A",
        "credential": "AG-PCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-24",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IA",
            "license": "AG02200055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "NIJDS.ORG",
            "affiliation": "N",
            "address_1": "1440 W Dunkerton Rd",
            "city": "Waterloo",
            "state": "IA",
            "country_code": "US",
            "postal_code": "507039648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.