Active NPI
Mikeal Freedom Mercedes, RNFA
- Registered Nurse First Assistant
- South Portland, ME
National Provider Identifier
1669745592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse First Assistant
- License
- RN46450
- Practice address
- 16 Memory LN
South Portland, ME 04106-6148 - Phone
- (207) 632-9706
- NPI assigned
- Feb 23, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse First Assistant | 163WR0006X | RN46450 | ME | Primary |
Addresses
Primary practice location
16 Memory LN
South Portland, ME 04106-6148
Mailing address
16 Memory LN
South Portland, ME 04106-6148
Phone (207) 632-9706
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN46450 | ME | MD | Registered Nurse First Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329955200000",
"number": "1669745592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 MEMORY LN",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041066148",
"telephone_number": "207-632-9706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 MEMORY LN",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041066148",
"telephone_number": "207-632-9706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERCEDES",
"first_name": "MIKEAL",
"middle_name": "FREEDOM",
"name_prefix": "Mr.",
"credential": "RNFA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-23",
"last_updated": "2012-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "163WR0006X",
"taxonomy_group": "",
"desc": "Registered Nurse, Registered Nurse First Assistant",
"state": "ME",
"license": "RN46450",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.