Active NPI
Charlie Joseph Fawcett, SON
- Home Health Agency
- Burton, MI
National Provider Identifier
1295440204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Practice address
- 4150 Boysenberry LN
Burton, MI 48529-2242 - Phone
- (810) 676-3220
- NPI assigned
- Jan 16, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
4150 Boysenberry LN
Burton, MI 48529-2242
Mailing address
11971 Juniper Way Apt 335
Grand Blanc, MI 48439-2142
Phone (810) 676-3222
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000000 | Other | MI | VA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673827200000",
"number": "1295440204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11971 JUNIPER WAY APT 335",
"city": "GRAND BLANC",
"state": "MI",
"postal_code": "484392142",
"telephone_number": "810-676-3222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4150 BOYSENBERRY LN",
"city": "BURTON",
"state": "MI",
"postal_code": "485292242",
"telephone_number": "810-676-3220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAWCETT",
"first_name": "CHARLIE",
"middle_name": "JOSEPH",
"credential": "SON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-01-16",
"last_updated": "2023-01-16",
"certification_date": "2023-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VA",
"identifier": "000000000",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.