Individual provider Active NPI

Michelle Thomas, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Dunedin, FL
National Provider Identifier
1700323748
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11009178 Issued in FL
Practice address
1504 Ohio Ave
Dunedin, FL 34698-4514
Phone
(734) 558-3401
NPI assigned
Jan 29, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F01170935 MI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704269910 MI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X C-APN.0101454-C-NP CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11009178 FL Primary

Addresses

Primary practice location

1504 Ohio Ave
Dunedin, FL 34698-4514

Mailing address

1504 Ohio Ave
Dunedin, FL 34698-4514

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240628001858 FL Practitioner - Nurse Practitioner 7719253897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F01170935MIMDFamily Nurse Practitioner
C-APN.0101454-C-NPCOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Mar 7, 2025 Accepting new patients
Revitalize Mental Health & Integrative Medicine LLC Psychiatric/Mental Health CurrentSince Dec 15, 2024 Accepting new patients

Locations

2759 State Road 580
Ste 212
Clearwater, FL 33761

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

8225 State Road 54
Trinity, FL 34655
Phone (727) 372-5206

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1485648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1700323748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 OHIO AVE",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346984514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 OHIO AVE",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346984514",
            "telephone_number": "734-558-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MICHELLE",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-29",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "F01170935",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704269910",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "C-APN.0101454-C-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11009178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunedin, FL

Sources for this page

Verify at the official NPI Registry.