Jean Skinner Michalove, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R122312 Issued in GA

Practice address

3602 Marathon Cir
Austell, GA 30106-6821

Phone

(770) 222-0253

Fax

(770) 222-9415

NPI assigned

Apr 26, 2020

Last updated

Apr 26, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jean Marie Michalove Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1587859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587859200000",
    "number": "1407476823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3490 BRIGHTON PL",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626243",
            "telephone_number": "770-354-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3602 MARATHON CIR",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301066821",
            "telephone_number": "770-222-0253",
            "fax_number": "770-222-9415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHALOVE",
        "first_name": "JEAN",
        "middle_name": "SKINNER",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-26",
        "last_updated": "2020-04-26",
        "certification_date": "2020-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "R122312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA RN",
            "identifier": "R122312",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEAN",
            "last_name": "MICHALOVE",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Nurse in Austell, GA
• Providers in Austell, GA by specialty
• Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2020; 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.