Individual provider Active NPI

Charles Michell

  • Home Health Agency
  • Las Vegas, NV
National Provider Identifier
1750684841
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
6048PCS-6 Issued in NV
Practice address
800 N Rainbow Blvd
212
Las Vegas, NV 89107-1189
Phone
(702) 293-3888
Fax
(702) 293-3664
NPI assigned
Dec 10, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 6048PCS-6 NV
Chore Provider 372500000X 6048PCS-6 NV
Home Health Aide 374U00000X 6048PCS-6 NV
Home Health Agency 251E00000X 6048PCS-6 NV Primary

Addresses

Primary practice location

800 N Rainbow Blvd
212
Las Vegas, NV 89107-1189

Mailing address

800 N Rainbow Blvd
212
Las Vegas, NV 89107-1189
Phone (702) 293-3888

Other practice location 1

800 N Rainbow Blvd Ste 165
Las Vegas, NV 89107-1189
Phone (702) 366-5864

Other identifiers 1

IdentifierTypeStateIssuer
1538546635MedicaidNV

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
6048PCS-6NVMDHome Health Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Graceful Touch, LLC Home Health CurrentSince Nov 28, 2021 Accepting new patients
Graceful Touch Home Health CurrentSince Nov 28, 2021 Accepting new patients

Locations

800 N Rainbow Blvd
Ste 28
Las Vegas, NV 89107
Phone (702) 293-3888

800 N Rainbow Blvd
Ste 212
Las Vegas, NV 89107
Phone (702) 293-3888

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": "1291939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1750684841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N RAINBOW BLVD",
            "address_2": "212",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071189",
            "telephone_number": "702-293-3888",
            "fax_number": "702-293-3664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N RAINBOW BLVD",
            "address_2": "212",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071189",
            "telephone_number": "702-293-3888",
            "fax_number": "702-293-3664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 N Rainbow Blvd Ste 165",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891071189",
            "country_code": "US",
            "telephone_number": "702-366-5864",
            "fax_number": "702-822-1042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICHELL",
        "first_name": "CHARLES",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "NV",
            "license": "6048PCS-6",
            "primary": false
        },
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": "NV",
            "license": "6048PCS-6",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "NV",
            "license": "6048PCS-6",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NV",
            "license": "6048PCS-6",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1538546635",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.