Active NPI
Tracy Brondyke
- Case Manager/Care Coordinator
- Jackson, MI
National Provider Identifier
1679074793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 300 W Louis Glick Hwy
Jackson, MI 49201-1228 - Phone
- (517) 782-9905
- NPI assigned
- Feb 23, 2018
- Last updated
- Feb 23, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | NU | Primary |
Addresses
Primary practice location
300 W Louis Glick Hwy
Jackson, MI 49201-1228
Mailing address
300 W Louis Glick Hwy
Jackson, MI 49201-1228
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Service and Childrens Aid | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Jackson, MI
- NPI 1699861609
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519344000000",
"number": "1679074793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 W LOUIS GLICK HWY",
"city": "JACKSON",
"state": "MI",
"postal_code": "492011228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W LOUIS GLICK HWY",
"city": "JACKSON",
"state": "MI",
"postal_code": "492011228",
"telephone_number": "517-782-9905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRONDYKE",
"first_name": "TRACY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-23",
"last_updated": "2018-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.