Individual provider Active NPI

Elizabeth Sally Hodge, LPN

  • Licensed Practical Nurse
  • Hartford, MI
National Provider Identifier
1023641420
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
4703050500 Issued in MI
Practice address
405 Oak St
Hartford, MI 49057-1339
Phone
(269) 993-7281
NPI assigned
Feb 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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 4703050500 MI Primary

Addresses

Primary practice location

405 Oak St
Hartford, MI 49057-1339

Mailing address

405 Oak St
Hartford, MI 49057-1339

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
4703050500MIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1581638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1023641420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 OAK ST",
            "city": "HARTFORD",
            "state": "MI",
            "postal_code": "490571339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 OAK ST",
            "city": "HARTFORD",
            "state": "MI",
            "postal_code": "490571339",
            "telephone_number": "269-993-7281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGE",
        "first_name": "ELIZABETH",
        "middle_name": "SALLY",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-14",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703050500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; 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.