Individual provider Active NPI

Sandra Lynn O'Neill, LBSW

  • Case Manager/Care Coordinator
  • Fort Gratiot, MI
National Provider Identifier
1699974923
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
6802073823 Issued in MI
Practice address
3847 Pine Grove Ave
Fort Gratiot, MI 48059-4265
Phone
(810) 985-4009
Fax
(810) 984-8111
NPI assigned
Jul 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 6802073823 MI Primary

Addresses

Primary practice location

3847 Pine Grove Ave
Fort Gratiot, MI 48059-4265

Mailing address

6660 Christine LN
Burtchville, MI 48059-2120
Phone (910) 385-3719

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

LicenseStateTypeSpecialty
6802073823MIMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184630400000",
    "number": "1699974923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6660 CHRISTINE LN",
            "city": "BURTCHVILLE",
            "state": "MI",
            "postal_code": "480592120",
            "telephone_number": "910-385-3719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3847 PINE GROVE AVE",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480594265",
            "telephone_number": "810-985-4009",
            "fax_number": "810-984-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEILL",
        "first_name": "SANDRA",
        "middle_name": "LYNN",
        "credential": "LBSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2007-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "MI",
            "license": "6802073823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gratiot, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; 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.