Active NPI
Michelle Ann Nolph, ANP
- Adult Health Nurse Practitioner
- California, MO
National Provider Identifier
1407081532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 2000147957
- Practice address
- 606 E Buchanan St
California, MO 65018-1910 - Phone
- (573) 796-3600
- NPI assigned
- May 19, 2009
- Last updated
- Oct 18, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 2000147957 | MO | Primary |
Addresses
Primary practice location
606 E Buchanan St
California, MO 65018-1910
Mailing address
PO Box 104240
Jefferson City, MO 65110-4240
Phone (573) 635-5264
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407081532 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382054400000",
"number": "1407081532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 104240",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651104240",
"telephone_number": "573-635-5264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "606 E BUCHANAN ST",
"city": "CALIFORNIA",
"state": "MO",
"postal_code": "650181910",
"telephone_number": "573-796-3600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLPH",
"first_name": "MICHELLE",
"middle_name": "ANN",
"credential": "ANP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-19",
"last_updated": "2013-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MO",
"license": "2000147957",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1407081532",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in California, MO
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- Pamida Stores Operating Co LLC (Pamida Pharmacy 853)
- Breanna Rae Pruitt
- Jill Denise Smith Radkowiec, OD
- Nicole E. Raithel
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.