Active NPI
Michelle Mary Waters, FNP
- Family Nurse Practitioner
- Hurricane, UT
National Provider Identifier
1558924746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 201157-4405
- Practice address
- 48 S 2500 W
Ste 240
Hurricane, UT 84737-3382 - Phone
- (801) 285-4200
- Fax
- (801) 285-4201
- NPI assigned
- Apr 15, 2019
- Last updated
- Sep 30, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 201157-4405 | UT | Primary |
Addresses
Primary practice location
48 S 2500 W
Ste 240
Hurricane, UT 84737-3382
Mailing address
48 S 2500 W
Ste 240
Hurricane, UT 84737-3382
Phone (801) 285-4200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2024 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201157-4405 | UT | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632960000000",
"number": "1558924746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48 S 2500 W",
"address_2": "STE 240",
"city": "HURRICANE",
"state": "UT",
"postal_code": "847373382",
"telephone_number": "801-285-4200",
"fax_number": "801-285-4201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "48 S 2500 W",
"address_2": "STE 240",
"city": "HURRICANE",
"state": "UT",
"postal_code": "847373382",
"telephone_number": "801-285-4200",
"fax_number": "801-285-4201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERS",
"first_name": "MICHELLE",
"middle_name": "MARY",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-15",
"last_updated": "2021-09-30",
"certification_date": "2021-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "UT",
"license": "201157-4405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hurricane, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.