Individual provider Active NPI

Michelle L Taylor, ANP

  • Adult Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1558519660
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP3119 Issued in AZ
Practice address
625 N 6TH St
Phoenix, AZ 85004-2155
Phone
(602) 406-8222
Fax
(602) 406-7811
NPI assigned
Sep 3, 2008
Last updated
Dec 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP3119 AZ Primary

Addresses

Primary practice location

625 N 6TH St
Phoenix, AZ 85004-2155

Mailing address

PO Box 33269
Phoenix, AZ 85067-3269
Phone (602) 406-4786

Other identifiers 1

IdentifierTypeStateIssuer
375847MedicaidAZ

Other names 1

  • Miss Michelle L Peck Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080925000084 AZ Practitioner - Nurse Practitioner 3870660343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sjhmc Physician ServicesGroup PAC ID 4486646197, 645 clinicians

Practice addresses (Care Compare)

625 N 6TH St
Phoenix, AZ 85004-2155
Phone (602) 406-8222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph's Hospital and Medical Center CurrentSince Aug 30, 2020 Accepting new patients
St Josephs Pathology Current Accepting new patients

Locations

3030 N Central Ave
Ste 1001
Phoenix, AZ 85012

350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001

625 N 6th St
Phoenix, AZ 85004
Phone (602) 406-8222

625 N 6th St
Ste 302
Phoenix, AZ 85004
Phone (602) 406-8222

File 56765
Los Angeles, CA 90074

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1558519660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33269",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850673269",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 N 6TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850042155",
            "telephone_number": "602-406-8222",
            "fax_number": "602-406-7811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP3119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375847",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "PECK",
            "middle_name": "L",
            "prefix": "MISS",
            "credential": "ANP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.