Active NPI
Sara R. Wutzke, R.N.
- Home Health Registered Nurse
- Saint Clair, MI
National Provider Identifier
1013313675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Registered Nurse
- License
- 4704214709
- Practice address
- 2430 Allington
Saint Clair, MI 48079-3602 - Phone
- (586) 219-2654
- NPI assigned
- Nov 10, 2014
- 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 |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | 4704214709 | MI | Primary |
Addresses
Primary practice location
2430 Allington
Saint Clair, MI 48079-3602
Mailing address
2430 Allington
Saint Clair, MI 48079-3602
Phone (586) 219-2654
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704214709 | MI | MD | Home Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415577600000",
"number": "1013313675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2430 ALLINGTON",
"city": "SAINT CLAIR",
"state": "MI",
"postal_code": "480793602",
"telephone_number": "586-219-2654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2430 ALLINGTON",
"city": "SAINT CLAIR",
"state": "MI",
"postal_code": "480793602",
"telephone_number": "586-219-2654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WUTZKE",
"first_name": "SARA",
"middle_name": "R.",
"credential": "R.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-10",
"last_updated": "2014-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "163WH0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Home Health",
"state": "MI",
"license": "4704214709",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Clair, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.