Individual provider Active NPI

Michelle Lee Frayne, NP-C

  • Family Nurse Practitioner
  • Madison, WI
National Provider Identifier
1528664885
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9910-33 Issued in WI
Practice address
650 Forward Dr.
Madison, WI 53711
Phone
(630) 891-2915
NPI assigned
Dec 10, 2020
Last updated
Dec 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9910-33 WI Primary

Addresses

Primary practice location

650 Forward Dr.
Madison, WI 53711

Mailing address

4505 Woods End
Madison, WI 53711-1420
Phone (319) 651-8903

Other practice location 1

4505 Woods End
Madison, WI 53711-1420
Phone (319) 651-8903

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231016000297 WI Order and Referring Only - General PracticePractitioner - General Practice 6608221429

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9910-33WIMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1528664885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 WOODS END",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537111420",
            "telephone_number": "319-651-8903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 FORWARD DR.",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53711",
            "telephone_number": "630-891-2915"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4505 Woods End",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537111420",
            "country_code": "US",
            "telephone_number": "319-651-8903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRAYNE",
        "first_name": "MICHELLE",
        "middle_name": "LEE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-10",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "9910-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.