Michael Charles Fitzgerald, RN,CNS

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

403758 Issued in CA

Practice address

203 Brackney Rd
Ben Lomond, CA 95005-9702

Phone

(831) 818-1934

NPI assigned

Jun 19, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Specialist, Registered Nurse

State licenses

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

{
    "created_epoch": "1655596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1417688722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 BRACKNEY RD",
            "city": "BEN LOMOND",
            "state": "CA",
            "postal_code": "950059702",
            "telephone_number": "831-818-1934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 BRACKNEY RD",
            "city": "BEN LOMOND",
            "state": "CA",
            "postal_code": "950059702",
            "telephone_number": "831-818-1934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "MICHAEL",
        "middle_name": "CHARLES",
        "credential": "RN,CNS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-19",
        "last_updated": "2025-09-11",
        "certification_date": "2022-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "403758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Email",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Info",
            "address_1": "203 Brackney Rd",
            "city": "Ben Lomond",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950059702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Registered Nurse in Ben Lomond, CA
• Providers in Ben Lomond, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.