Active NPI
Michelle Pannell, CST, LSA
- Surgical Assistant
- Crowley, TX
National Provider Identifier
1316335599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- SA00566
- Practice address
- 2104 Builder Rd
Crowley, TX 76036-4611 - Phone
- (817) 675-8299
- NPI assigned
- Dec 22, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Technologist | 246ZS0410X | 143701 | TX | |
| Surgical Assistant | 246ZC0007X | SA00566 | TX | Primary |
Addresses
Primary practice location
2104 Builder Rd
Crowley, TX 76036-4611
Mailing address
2104 Builder Rd
Crowley, TX 76036-4611
Phone (817) 675-8299
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA00566 | TX | MD | Surgical Assistant |
| 143701 | TX | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497830400000",
"number": "1316335599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2104 BUILDER RD",
"city": "CROWLEY",
"state": "TX",
"postal_code": "760364611",
"telephone_number": "817-675-8299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2104 BUILDER RD",
"city": "CROWLEY",
"state": "TX",
"postal_code": "760364611",
"telephone_number": "817-675-8299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANNELL",
"first_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "CST, LSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-12-22",
"last_updated": "2017-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": "TX",
"license": "143701",
"primary": false
},
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "TX",
"license": "SA00566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crowley, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.