Individual provider Active NPI

Michelle Chavous Myers, APRN

  • Family Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1669404950
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
715 Issued in SC
Practice address
1735 Saint Julian PL Ste 102
Columbia, SC 29204-2402
Phone
(803) 497-9611
Fax
(803) 764-2003
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 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 715 SC Primary

Addresses

Primary practice location

1735 Saint Julian PL Ste 102
Columbia, SC 29204-2402

Mailing address

1735 Saint Julian PL Ste 102
Columbia, SC 29204-2402
Phone (803) 497-9611

Other practice location 1

220 Faison Dr
Columbia, SC 29203-3210
Phone (803) 898-8405

Other identifiers 2

IdentifierTypeStateIssuer
NP0231MedicaidSC
NP1704MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Columbia

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
Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: michelle.myers.p1@direct.scdc.nextgenshare.com
  • Direct secure messaging: michelle.myers.p1@direct.ncfmc.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1669404950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 SAINT JULIAN PL STE 102",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042402",
            "telephone_number": "803-497-9611",
            "fax_number": "803-764-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 SAINT JULIAN PL STE 102",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042402",
            "telephone_number": "803-497-9611",
            "fax_number": "803-764-2003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Faison Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292033210",
            "country_code": "US",
            "telephone_number": "803-898-8405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYERS",
        "first_name": "MICHELLE",
        "middle_name": "CHAVOUS",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0231",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1704",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Columbia",
            "affiliation": "N",
            "address_1": "1735 Saint Julian Pl Ste 102",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292042402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; 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.