Sandra Dejong

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704214378 Issued in MI

Practice address

8906 M 89
Richland, MI 49083

Phone

(269) 286-7130

Fax

(269) 286-7131

NPI assigned

Aug 30, 2006

Last updated

Mar 22, 2023By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Beacon Medical Group Michigan Inc

  dba Beacon Medical Group Michigan

  • Family Medicine Physician
  • Portage, MI
  • NPI 1497709869
  Medicare reassignment NPD
• Beacon Medical Group Michigan Inc

  • Pediatrics Physician
  • Sturgis, MI
  • NPI 1013926997
  NPD
• Promed Healthcare

  dba Borgess Women's Health

  • Rural Health Clinic/Center
  • Plainwell, MI
  • NPI 1487708830
  NPD

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1447360433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JOHN ST # 42",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8906 M 89",
            "city": "RICHLAND",
            "state": "MI",
            "postal_code": "49083",
            "telephone_number": "269-286-7130",
            "fax_number": "269-286-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJONG",
        "first_name": "SANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704214378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Compass Physical Therapy Specialists
• Comprehensive Psychological and Assessment Services, LLC
• Jason Michael Corradini, D.D.S.
• Cheryl Czerney, NP
• Brianne Nicole Deboer, FNP
• Emily E Derhammer, FNP-C
• Maribel Xiomara Diaz-Munoz-Laforge, MS, LMHC, LPC
• Ashley Elizabeth Diehl, MD
• Linda Dolbee
• Paul Joseph Ellis, D.D.S.

• Nurse Practitioner in Richland, MI
• Providers in Richland, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.