Individual provider Active NPI

Mikelyn Calhoun, RN, BSN,CDE

  • Diabetes Educator Registered Nurse
  • Prattville, AL
National Provider Identifier
1497920649
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
License
1078255 Issued in AL
Practice address
200 Medical Center Drive
Prattville, AL 36066
Phone
(334) 361-6380
Fax
(334) 220-3590
NPI assigned
Apr 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X 1078255 AL Primary

Addresses

Primary practice location

200 Medical Center Drive
Prattville, AL 36066

Mailing address

10101 Linn Station Rd
Suite 560
Louisville, KY 40223-3848
Phone (502) 657-0440

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
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
1078255ALMDDiabetes Educator Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1497920649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 LINN STATION RD",
            "address_2": "SUITE 560",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402233848",
            "telephone_number": "502-657-0440",
            "fax_number": "502-657-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL CENTER DRIVE",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "36066",
            "telephone_number": "334-361-6380",
            "fax_number": "334-220-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALHOUN",
        "first_name": "MIKELYN",
        "name_prefix": "Mrs.",
        "credential": "RN, BSN,CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "AL",
            "license": "1078255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prattville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.