Individual provider Active NPI

Sarah Irene McKay, FNP

  • Nurse Practitioner
  • Saint Joseph, MI
National Provider Identifier
1376847715
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704408577 Issued in MI
Practice address
3901 Stonegate Park Ste 100
Saint Joseph, MI 49085-9136
Phone
(269) 281-7042
Fax
(269) 235-9507
NPI assigned
Dec 28, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704408577 MI Primary

Addresses

Primary practice location

3901 Stonegate Park Ste 100
Saint Joseph, MI 49085-9136

Mailing address

68498 Beebe Rd
Niles, MI 49120-6038
Phone (269) 281-7042

Other identifiers 1

IdentifierTypeStateIssuer
4704408577OtherMINP LICENSE

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704408577MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elkhart General Hospital, Inc. Past Accepting new patients
Elkhart General Hospital Inc PastSince Apr 1, 2010 Accepting new patients

Organizations & group practices 2

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": "1293494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1376847715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68498 BEEBE RD",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491206038",
            "telephone_number": "269-281-7042",
            "fax_number": "269-235-9507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 STONEGATE PARK STE 100",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859136",
            "telephone_number": "269-281-7042",
            "fax_number": "269-235-9507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKAY",
        "first_name": "SARAH",
        "middle_name": "IRENE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-28",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704408577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE",
            "identifier": "4704408577",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.

Verify at the official NPI Registry.