Individual provider Active NPI

Abigail Berke Parker, NP

  • Nurse Practitioner
  • Sault Sainte Marie, MI
National Provider Identifier
1699503524
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704279432 Issued in MI
Practice address
650 W Easterday Ave
Sault Sainte Marie, MI 49783-1626
Phone
(906) 635-2418
Fax
(906) 635-0337
NPI assigned
Jul 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 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 4704279432 MI Primary

Addresses

Primary practice location

650 W Easterday Ave
Sault Sainte Marie, MI 49783-1626

Mailing address

650 W Easterday Ave
Sault Sainte Marie, MI 49783-1626
Phone (906) 635-2418

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241003002795 MI Practitioner - Nurse Practitioner 1052842838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Superior State UniversityGroup PAC ID 9335193960, 2 clinicians

Practice addresses (Care Compare)

650 W Easterday Ave
Sault Sainte Marie, MI 49783-1626
Phone (906) 635-2110

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704279432MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Superior State University Nurse Practitioner CurrentSince Sep 1, 2024 Accepting new patients

Locations

650 W Easterday Ave
Sault South Marie, MI 49783
Phone (906) 635-2110

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1721692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1699503524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 W EASTERDAY AVE",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497831626",
            "telephone_number": "906-635-2418",
            "fax_number": "906-635-0337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 W EASTERDAY AVE",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497831626",
            "telephone_number": "906-635-2418",
            "fax_number": "906-635-0337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "ABIGAIL",
        "middle_name": "BERKE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-23",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704279432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sault Sainte Marie, MI

Sources for this page

Verify at the official NPI Registry.