Individual provider Active NPI

Michele Diane Robillard, LPN

  • Licensed Practical Nurse
  • Edwards, NY
National Provider Identifier
1750112819
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
133231-01 Issued in NY
Practice address
1395 State Highway 58
Edwards, NY 13635-3158
Phone
(315) 212-2003
NPI assigned
Aug 12, 2024
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Clinical Nurse Specialist 364SH0200X 133231-01 NY
Licensed Practical Nurse 164W00000X 133231-01 NY Primary

Addresses

Primary practice location

1395 State Highway 58
Edwards, NY 13635-3158

Mailing address

1395 State Highway 58
Edwards, NY 13635-3158
Phone (315) 212-2003

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

LicenseStateTypeSpecialty
133231-01NYMDHome Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1750112819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 STATE HIGHWAY 58",
            "city": "EDWARDS",
            "state": "NY",
            "postal_code": "136353158",
            "telephone_number": "315-212-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 STATE HIGHWAY 58",
            "city": "EDWARDS",
            "state": "NY",
            "postal_code": "136353158",
            "telephone_number": "315-212-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBILLARD",
        "first_name": "MICHELE",
        "middle_name": "DIANE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SH0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Home Health",
            "state": "NY",
            "license": "133231-01",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "133231-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwards, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.