Active NPI
Jessie Maurer
- Registered Nurse
- Bad Axe, MI
National Provider Identifier
1003464397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 4704301080
- Practice address
- 1375 R Dale Wertz Dr
Bad Axe, MI 48413-1365 - Phone
- (989) 269-9293
- NPI assigned
- Aug 29, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 4704301080 | MI | Primary |
Addresses
Primary practice location
1375 R Dale Wertz Dr
Bad Axe, MI 48413-1365
Mailing address
5080 Ruth Rd
Ruth, MI 48470-9732
Phone (810) 837-2031
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4704301080 | MI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567036800000",
"number": "1003464397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5080 RUTH RD",
"city": "RUTH",
"state": "MI",
"postal_code": "484709732",
"telephone_number": "810-837-2031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1375 R DALE WERTZ DR",
"city": "BAD AXE",
"state": "MI",
"postal_code": "484131365",
"telephone_number": "989-269-9293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAURER",
"first_name": "JESSIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-29",
"last_updated": "2019-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MI",
"license": "4704301080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bad Axe, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.