Individual provider Active NPI

Michelle R. Nelson

  • Family Nurse Practitioner
  • Baton Rouge, LA
National Provider Identifier
1821370032
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP06638 Issued in LA
Practice address
7777 Hennessy Blvd Ste 612
Baton Rouge, LA 70808-4366
Phone
(225) 769-5656
Fax
(225) 766-6996
NPI assigned
Sep 13, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP06638 LA Primary

Addresses

Primary practice location

7777 Hennessy Blvd Ste 612
Baton Rouge, LA 70808-4366

Mailing address

7500 Hennessy Blvd
Baton Rouge, LA 70808-4339
Phone (225) 768-1777

Other practice location 1

7500 Hennessy Blvd
Baton Rouge, LA 70808-4339
Phone (225) 768-1777

Other practice location 2

7777 Hennessy Blvd Ste 612
Baton Rouge, LA 70808-4366
Phone (225) 769-5656

Other identifiers 1

IdentifierTypeStateIssuer
2316206MedicaidLA

Other names 1

  • Michelle R. Robins Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other
Direct Messaging Address mnelson15915@direct.casso.us.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20140716001346 LA Practitioner - Nurse Practitioner 3779709365 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC CurrentSince May 4, 2014 Accepting new patients
Our Lady of the Lake Physician Group LLC Nurse Practitioner CurrentSince May 4, 2014 Accepting new patients

Locations

2051 Silverside Dr
Ste 260
Baton Rouge, LA 70808
Phone (225) 490-6301

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

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": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1821370032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 HENNESSY BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084339",
            "telephone_number": "225-768-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD STE 612",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084366",
            "telephone_number": "225-769-5656",
            "fax_number": "225-766-6996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7500 Hennessy Blvd",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708084339",
            "country_code": "US",
            "telephone_number": "225-768-1777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7777 Hennessy Blvd Ste 612",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708084366",
            "country_code": "US",
            "telephone_number": "225-769-5656",
            "fax_number": "225-766-6996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MICHELLE",
        "middle_name": "R.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-13",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP06638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2316206",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "EPIC FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "7777 Hennessy Blvd Ste 612",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708084366",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mnelson15915@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mnelson15915@direct.casso.us.com",
            "address_1": "7777 Hennessy Blvd Ste 612",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708084366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "ROBINS",
            "middle_name": "R.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.