Active NPI
Corey Masuga
- Social Worker
- Sault Sainte Marie, MI
National Provider Identifier
1497906838
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801090492
- Practice address
- 3865 S Mackinac TRL
Sault Sainte Marie, MI 49783-9286 - Phone
- (906) 632-2805
- NPI assigned
- Oct 3, 2008
- Last updated
- Feb 1, 2013
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801090492 | MI | Primary |
Addresses
Primary practice location
3865 S Mackinac TRL
Sault Sainte Marie, MI 49783-9286
Mailing address
125 N Lake St
Manistique, MI 49854
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 |
|---|---|---|---|
| 6801090492 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359676800000",
"number": "1497906838",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 N LAKE ST",
"city": "MANISTIQUE",
"state": "MI",
"postal_code": "49854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3865 S MACKINAC TRL",
"city": "SAULT SAINTE MARIE",
"state": "MI",
"postal_code": "497839286",
"telephone_number": "906-632-2805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASUGA",
"first_name": "COREY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-10-03",
"last_updated": "2013-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801090492",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sault Sainte Marie, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.