Individual provider Active NPI

Mickelyn Graves Houghton, APRN-CNM

  • Advanced Practice Midwife
  • Lakeland, FL
National Provider Identifier
1356063911
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
APRN11021795 Issued in FL
Practice address
1129 N Missouri Ave
Lakeland, FL 33805-4411
Phone
(866) 234-8534
NPI assigned
Sep 12, 2022
Last updated
Feb 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X APRN11021795 FL Primary

Addresses

Primary practice location

1129 N Missouri Ave
Lakeland, FL 33805-4411

Mailing address

47 5TH St NW
Winter Haven, FL 33881-4672
Phone (866) 234-8534

Other practice location 1

165 Montgomery Rd
Altamonte Springs, FL 32714-3102
Phone (407) 878-2757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240301000659 FL Practitioner - Certified Nurse Midwife (CNM) 0143665018 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Tree of Life Birth and Gynecology Advanced Practice Midwife CurrentSince Nov 24, 2024 Accepting new patients
Central Florida Health Care, Inc. Current Accepting new patients
Central Florida Health Care, Inc CurrentSince Feb 26, 2024 Accepting new patients
Central Florida Health Care, Inc. CurrentSince Feb 26, 2024 Accepting new patients
Central Florida Health Care, Inc. Past Accepting new patients
Central Florida Health Care, Inc. Past Accepting new patients
Central Florida Health Care, Inc. Past Accepting new patients
Central Florida Health Care, Inc Past Accepting new patients
Central Florida Health Care Inc Past Accepting new patients
Central Florida Health Care, Inc. Past Accepting new patients
Central Florida Health Care, Inc. Past Accepting new patients
Central Florida Health Care Inc Past Accepting new patients
Central Florida Health Care, Inc Past Accepting new patients

Locations

165 Montgomery Rd
Altamonte Springs, FL 32714
Phone (407) 878-2757

950 County Road 17A W
Avon Park, FL 33825
Phone (863) 452-3000

109 W Wall St
Frostproof, FL 33843
Phone (863) 635-4891

305 W Central Ave
Fl Heal
Lake Wales, FL 33853

1129 N Missouri Ave
Lakeland, FL 33805
Phone (863) 413-8600

47 5th St NW
Winter Haven, FL 33881

Interoperability endpoints

  • Direct secure messaging: mickelyn.houghton.1@12125.direct.athenahealth.com

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1356063911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 5TH ST NW",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814672",
            "telephone_number": "866-234-8534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 N MISSOURI AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054411",
            "telephone_number": "866-234-8534"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "165 Montgomery Rd",
            "address_purpose": "LOCATION",
            "city": "Altamonte Springs",
            "state": "FL",
            "postal_code": "327143102",
            "country_code": "US",
            "telephone_number": "407-878-2757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOUGHTON",
        "first_name": "MICKELYN",
        "middle_name": "GRAVES",
        "name_prefix": "Mrs.",
        "credential": "APRN-CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-12",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "APRN11021795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.