Individual provider Active NPI

Sarah Frederick, MSW

  • Clinical Social Worker
  • Portage, MI
National Provider Identifier
1144760604
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801086245 Issued in MI
Practice address
2600 W Centre Ave
Portage, MI 49024-4828
Phone
(269) 324-4141
Fax
(269) 324-2020
NPI assigned
Mar 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801086245 MI Primary

Addresses

Primary practice location

2600 W Centre Ave
Portage, MI 49024-4828

Mailing address

2600 W Centre Ave
Portage, MI 49024-4828
Phone (269) 324-4141

Other names 1

  • Sarah Gulbranson Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct.direct@bronsonhg.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170320001170 MI Practitioner - Clinical Social Worker 0547545212 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Lakeview Hospital CurrentSince Oct 1, 2020 Accepting new patients
Bronson Battle Creek Hospital CurrentSince May 1, 2020 Accepting new patients
Bronson South Haven Hospital CurrentSince Oct 1, 2020 Accepting new patients
Bronson Lakeview Hospital CurrentSince Oct 1, 2020 Accepting new patients
Bronson Methodist Hospital CurrentSince Feb 20, 2017 Accepting new patients
Bronson Battle Creek Hospital CurrentSince May 1, 2020 Accepting new patients
Bronson South Haven Hospital CurrentSince Oct 1, 2020 Accepting new patients

Locations

363 Fremont St
Ste 308
Battle Creek, MI 49017
Phone (269) 245-8310

300 North Ave
Fl 2
Battle Creek, MI 49017
Phone (269) 245-5862

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

451 Health Pkwy
Ste A
Paw Paw, MI 49079
Phone (269) 655-3065

451 Health Pkwy
Paw Paw, MI 49079
Phone (269) 655-1725

2600 W Centre Ave
Portage, MI 49024
Phone (269) 324-4141

950 S Bailey Ave
South Haven, MI 49090
Phone (269) 639-2796

Organizations & group practices 7

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": "1488499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1144760604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 W CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244828",
            "telephone_number": "269-324-4141",
            "fax_number": "269-324-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 W CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244828",
            "telephone_number": "269-324-4141",
            "fax_number": "269-324-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "SARAH",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-03",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801086245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct.direct@bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "GULBRANSON",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portage, MI

Sources for this page

Verify at the official NPI Registry.