Individual provider Active NPI

Michelle Rene Menke, NP-C

  • Family Nurse Practitioner
  • Lima, OH
National Provider Identifier
1659642858
Registry record updated Jan 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA. 13042-NP Issued in OH
Practice address
825 S Cable Rd
Suite a
Lima, OH 45805-3467
Phone
(419) 224-1234
NPI assigned
Jan 19, 2012
Last updated
Jan 19, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2012

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 COA. 13042-NP OH Primary

Addresses

Primary practice location

825 S Cable Rd
Suite a
Lima, OH 45805-3467

Mailing address

825 S Cable Rd
Suite a
Lima, OH 45805-3467
Phone (419) 224-1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20120307000221 OH Practitioner - Nurse Practitioner 1850550013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leahy Family Care IncGroup PAC ID 7214958297, 2 clinicians

Practice addresses (Care Compare)

825 S Cable Rd
Suite a
Lima, OH 45805-3467
Phone (419) 224-1234

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA. 13042-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Leahy Family Care Inc CurrentSince Jan 23, 2011 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

825 S Cable Rd
Ste A
Lima, OH 45805
Phone (419) 224-1234

Organizations & group practices 2

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 3

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": "1326931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326931200000",
    "number": "1659642858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 S CABLE RD",
            "address_2": "SUITE A",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458053467",
            "telephone_number": "419-224-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 S CABLE RD",
            "address_2": "SUITE A",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458053467",
            "telephone_number": "419-224-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENKE",
        "first_name": "MICHELLE",
        "middle_name": "RENE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-19",
        "last_updated": "2012-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA. 13042-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.