Individual provider Active NPI

Rhonda Wisenbaugh, SOCIAL WORKER

  • Social Worker
  • Bad Axe, MI
National Provider Identifier
1114342573
Registry record updated Feb 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6802071575 Issued in MI
Practice address
1263 Sand Beach Rd
Bad Axe, MI 48413-8817
Phone
(989) 269-9229
Fax
(989) 269-2587
NPI assigned
Feb 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6802071575 MI Primary

Addresses

Primary practice location

1263 Sand Beach Rd
Bad Axe, MI 48413-8817

Mailing address

1218 W Richardson Rd
Bad Axe, MI 48413-9729
Phone (989) 269-9229

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
6802071575MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thumb Industries, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1392940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392940800000",
    "number": "1114342573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 W RICHARDSON RD",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484139729",
            "telephone_number": "989-269-9229",
            "fax_number": "989-269-2587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1263 SAND BEACH RD",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484138817",
            "telephone_number": "989-269-9229",
            "fax_number": "989-269-2587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISENBAUGH",
        "first_name": "RHONDA",
        "name_prefix": "Mrs.",
        "credential": "SOCIAL WORKER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-21",
        "last_updated": "2014-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802071575",
            "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 Feb 21, 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.

Verify at the official NPI Registry.