Summer Hulsebus

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

10508 275TH Ave NW
Zimmerman, MN 55398-4377

Phone

(218) 410-1486

NPI assigned

Sep 30, 2022

Last updated

Sep 30, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Autism Services of Minnesota

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hugo, MN
  • NPI 1538820899
  NPD (past)

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

{
    "created_epoch": "1664496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1396469581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10508 275TH AVE NW",
            "city": "ZIMMERMAN",
            "state": "MN",
            "postal_code": "553984377",
            "telephone_number": "218-410-1486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10508 275TH AVE NW",
            "city": "ZIMMERMAN",
            "state": "MN",
            "postal_code": "553984377",
            "telephone_number": "218-410-1486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULSEBUS",
        "first_name": "SUMMER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-30",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A253960200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brianna Galang, PA-C
• Dan Haack, P.T.
• Donna Haberle
• Jean Ann Hartley, LM, CPM
• Brian L Hoffmann, DC
• Rebecca Ikier
• Danielle Kalor
• Anna K Kemp
• Ciara Jewel-Ann King
• Ja'Shawna King

• Behavior Technician in Zimmerman, MN
• Providers in Zimmerman, MN by specialty
• Behavior Technician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.