Individual provider Active NPI

Susan Marie Micheli, PA-C

  • Medical Physician Assistant
  • Fort Knox, KY
National Provider Identifier
1316924442
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1445 Issued in WI
Practice address
289 Ireland Ave
Ireland Community Hospital
Fort Knox, KY 40121-5111
Phone
(502) 624-9007
Fax
(502) 624-0252
NPI assigned
Dec 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1445 WI Primary

Addresses

Primary practice location

289 Ireland Ave
Ireland Community Hospital
Fort Knox, KY 40121-5111

Mailing address

289 Ireland Ave
Ireland Community Hospital
Fort Knox, KY 40121-5111
Phone (502) 624-9007

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

LicenseStateTypeSpecialty
1445WIMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1316924442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 IRELAND AVE",
            "address_2": "IRELAND COMMUNITY HOSPITAL",
            "city": "FORT KNOX",
            "state": "KY",
            "postal_code": "401215111",
            "telephone_number": "502-624-9007",
            "fax_number": "502-624-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 IRELAND AVE",
            "address_2": "IRELAND COMMUNITY HOSPITAL",
            "city": "FORT KNOX",
            "state": "KY",
            "postal_code": "401215111",
            "telephone_number": "502-624-9007",
            "fax_number": "502-624-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHELI",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "1445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Knox, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.