NPIMap

Organization Active NPI

Segue Inc

  • Adult Mental Health Clinic/Center
  • Jackson, MI
National Provider Identifier
1174634315
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
SEGUE INC
Practice address
212 E. Biddle Street
Jackson, MI 49203
Phone
(517) 784-6729
Fax
(517) 745-4841
NPI assigned
Aug 31, 2006
Last updated
Feb 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Authorized official

Name
Diane M Reynolds
Title
Ceo
Phone
(517) 784-6729

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU Primary

Addresses

Primary practice location

212 E. Biddle Street
Jackson, MI 49203

Mailing address

PO Box 6159
Jackson, MI 49204-6159
Phone (517) 784-6729

Other identifiers 2

IdentifierTypeStateIssuer
4924298MedicaidMI
260C811710OtherMIBLUE CROSS BLUE SHLD MICH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060929000219 MI Part B Supplier - Clinic/Group Practice 6800891680 Receives reassigned benefits from 7 practitioners
Practice locations: Hillsdale, MI; Jackson, MI

National Provider Directory

National Provider Directory

Locations

3200 W Carleton Rd
Hillsdale, MI 49242
Phone (517) 437-0114

2301 E Michigan Ave
Ste 100
Jackson, MI 49202
Phone 51778467297014

Practitioners & affiliated clinicians

Practitioners 39

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580688000000",
    "number": "1174634315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6159",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492046159",
            "telephone_number": "517-784-6729",
            "fax_number": "517-784-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 E. BIDDLE STREET",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "49203",
            "telephone_number": "517-784-6729",
            "fax_number": "517-745-4841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEGUE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "517-784-6729"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4924298",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHLD MICH",
            "identifier": "260C811710",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.