Individual provider Active NPI

Michael Brian Pierce, FNP-C

  • Family Nurse Practitioner
  • Dothan, AL
National Provider Identifier
1811597073
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-169105 Issued in AL
Practice address
1093 Ross Clark Cir
Dothan, AL 36303-5424
Phone
(334) 699-6396
NPI assigned
Oct 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-169105 AL Primary
Registered Nurse 163W00000X 1-169105 AL

Addresses

Primary practice location

1093 Ross Clark Cir
Dothan, AL 36303-5424

Mailing address

1093 Ross Clark Cir
Dothan, AL 36303-5424
Phone (334) 699-6396

Other practice location 1

1108 Ross Clark Cir
Dothan, AL 36301-3022
Phone (334) 343-6397

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20221107001326 AL Practitioner - Nurse Practitioner 7315314226 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Cardiology Consultants Inc CurrentSince Jul 28, 2022 Accepting new patients

Locations

109 Medical Park Dr
Ste A
Andalusia, AL 36420
Phone (214) 701-7816

1118 Ross Clark Cir
Ste 704
Dothan, AL 36301
Phone (334) 794-5335

1093 Ross Clark Cir
Dothan, AL 36303
Phone (214) 701-7816

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1811597073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1093 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363035424",
            "telephone_number": "334-699-6396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1093 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363035424",
            "telephone_number": "334-699-6396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1108 Ross Clark Cir",
            "address_purpose": "LOCATION",
            "city": "Dothan",
            "state": "AL",
            "postal_code": "363013022",
            "country_code": "US",
            "telephone_number": "334-343-6397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIERCE",
        "first_name": "MICHAEL",
        "middle_name": "BRIAN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-27",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-169105",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-169105",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.