Individual provider Active NPI

Michelle Marshall, CRNA

  • Certified Registered Nurse Anesthetist
  • Rockledge, FL
National Provider Identifier
1659317758
Registry record updated Feb 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9206758 Issued in FL
Practice address
110 Longwood Ave
Rockledge, FL 32955-2828
Phone
(407) 667-0444
Fax
(407) 667-4338
NPI assigned
Jun 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X ARNP9206758 FL Primary

Addresses

Primary practice location

110 Longwood Ave
Rockledge, FL 32955-2828

Mailing address

291 Southhall LN
Suite 201
Maitland, FL 32751-7274
Phone (407) 667-0444

Other identifiers 2

IdentifierTypeStateIssuer
305808400MedicaidFL
G3504OtherFLBCBS

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)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Volusia Anesthesia Associates Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203292800000",
    "number": "1659317758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 SOUTHHALL LN",
            "address_2": "SUITE 201",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517274",
            "telephone_number": "407-667-0444",
            "fax_number": "407-667-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LONGWOOD AVE",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552828",
            "telephone_number": "407-667-0444",
            "fax_number": "407-667-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "MICHELLE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2008-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9206758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305808400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "G3504",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.