Individual provider Active NPI

Michelle L Backus, LPN

  • Licensed Practical Nurse
  • Mount Morris, NY
National Provider Identifier
1992019673
Registry record updated Aug 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
10-301904 Issued in NY
Practice address
29 State St
Mount Morris, NY 14510-1146
Phone
(585) 519-9426
NPI assigned
Aug 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 10-301904 NY Primary

Addresses

Primary practice location

29 State St
Mount Morris, NY 14510-1146

Mailing address

29 State St
Mount Morris, NY 14510-1146

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
10-301904NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1280966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280966400000",
    "number": "1992019673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 STATE ST",
            "city": "MOUNT MORRIS",
            "state": "NY",
            "postal_code": "145101146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 STATE ST",
            "city": "MOUNT MORRIS",
            "state": "NY",
            "postal_code": "145101146",
            "telephone_number": "585-519-9426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACKUS",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-05",
        "last_updated": "2010-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "10-301904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Morris, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; 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.