Individual provider Active NPI

Michelle Ann Nulton, FNP

  • Nurse Practitioner
  • Binghamton, NY
National Provider Identifier
1306837810
Registry record updated Mar 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3315961 Issued in NY
Practice address
169 Riverside Dr
Suite 307
Binghamton, NY 13905-4246
Phone
(607) 798-5897
NPI assigned
Nov 3, 2005
Last updated
Mar 6, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2012

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 3315961 NY Primary

Addresses

Primary practice location

169 Riverside Dr
Suite 307
Binghamton, NY 13905-4246

Mailing address

169 Riverside Dr
Suite 307
Binghamton, NY 13905-4246
Phone (607) 798-5897

Other identifiers 1

IdentifierTypeStateIssuer
01790367MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20081212000169 NY Practitioner - Nurse Practitioner 6608937313 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3315961NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of Lourdes Memorial Hospital, Inc. Nurse Practitioner Current Accepting new patients
Our Lady of Lourdes Memorial Hospital Inc. CurrentSince Mar 1, 2011 Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Mar 1, 2011 Accepting new patients
Twin Tier Pathology Associates, PC Current Accepting new patients
Chenango Memorial Hospital, Inc. Nurse Practitioner Past Accepting new patients

Locations

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

169 Riverside Dr
#L
Binghamton, NY 13905
Phone (607) 798-5474

169 Riverside Dr
Ste 206
Binghamton, NY 13905
Phone (607) 798-6701

169 Riverside Dr
Ste 307
Binghamton, NY 13905
Phone (607) 798-5671

276-280 Robinson St
Binghamton, NY 13904
Phone (607) 722-2769

39 E Main St
Hancock, NY 13783
Phone (607) 637-5700

500 5th Ave
Owego, NY 13827
Phone (607) 687-1122

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.

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330992000000",
    "number": "1306837810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 RIVERSIDE DR",
            "address_2": "SUITE 307",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139054246",
            "telephone_number": "607-798-5897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 RIVERSIDE DR",
            "address_2": "SUITE 307",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139054246",
            "telephone_number": "607-798-5897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NULTON",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-03",
        "last_updated": "2012-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "3315961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01790367",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

Verify at the official NPI Registry.