Active NPI
Carol M Von Michaelis, PA-C
- Physician Assistant
- Centennial, CO
National Provider Identifier
1891941910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2626
- Practice address
- 14000 E Arapahoe Rd
#300
Centennial, CO 80112-4028 - Phone
- (720) 979-0840
- Fax
- (303) 861-4741
- NPI assigned
- Aug 8, 2008
- Last updated
- Jun 14, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2626 | CO | Primary |
Addresses
Primary practice location
14000 E Arapahoe Rd
#300
Centennial, CO 80112-4028
Mailing address
720 S Colorado Blvd
#220A
Glendale, CO 80246-1912
Phone (720) 979-0840
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12987271 | Medicaid | CO |
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)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children's Hospital Colorado | Current | Accepting new patients | |
| Children's Hospital Colorado | Past | Accepting new patients |
Interoperability endpoints
- cvonmichaelis245225@direct.childrenscolorado.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308009600000",
"number": "1891941910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 S COLORADO BLVD",
"address_2": "#220A",
"city": "GLENDALE",
"state": "CO",
"postal_code": "802461912",
"telephone_number": "720-979-0840",
"fax_number": "303-861-4741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14000 E ARAPAHOE RD",
"address_2": "#300",
"city": "CENTENNIAL",
"state": "CO",
"postal_code": "801124028",
"telephone_number": "720-979-0840",
"fax_number": "303-861-4741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VON MICHAELIS",
"first_name": "CAROL",
"middle_name": "M",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-08",
"last_updated": "2011-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CO",
"license": "2626",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "12987271",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Centennial, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.