Active NPI
Sabrina Costner
- In Home Supportive Care Agency
- Benton Harbor, MI
National Provider Identifier
1205688801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- License
- 5574025
- Practice address
- 637 N Wells Ave
Benton Harbor, MI 49022-7711 - Phone
- (269) 332-9841
- NPI assigned
- Apr 5, 2024
- Last updated
- Apr 5, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | 5574025 | MI | Primary |
Addresses
Primary practice location
637 N Wells Ave
Benton Harbor, MI 49022-7711
Mailing address
4891 E Britain Ave
Benton Harbor, MI 49022-9731
Phone (269) 487-0744
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5574025 | MI | MD | In Home Supportive Care Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712275200000",
"number": "1205688801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4891 E BRITAIN AVE",
"city": "BENTON HARBOR",
"state": "MI",
"postal_code": "490229731",
"telephone_number": "269-487-0744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "637 N WELLS AVE",
"city": "BENTON HARBOR",
"state": "MI",
"postal_code": "490227711",
"telephone_number": "269-332-9841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTNER",
"first_name": "SABRINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-04-05",
"last_updated": "2024-04-05",
"certification_date": "2024-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "MI",
"license": "5574025",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Benton Harbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.