Individual provider Active NPI

Sarah Suzanne Bruney, NP

  • Nurse Practitioner
  • Saint Johns, MI
National Provider Identifier
1710281563
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704280113 Issued in MI
Practice address
1501 Waterford Pkwy Ste B
Saint Johns, MI 48879-9631
Phone
(989) 534-2370
Fax
(989) 534-2371
NPI assigned
Jan 7, 2011
Last updated
May 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2020

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 4704280113 MI Primary

Addresses

Primary practice location

1501 Waterford Pkwy Ste B
Saint Johns, MI 48879-9631

Mailing address

1501 Waterford Pkwy Ste B
Saint Johns, MI 48879-9631
Phone (989) 534-2370

Other practice location 1

818 W King St Ste 101
Owosso, MI 48867-2117
Phone (989) 723-1390

Other identifiers 1

IdentifierTypeStateIssuer
1710281563MedicaidMI

Other names 1

  • Sarah S Frey Former name

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)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Nurse Practitioner Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: s.bruney@memorialhealthcare.midirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1294358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1710281563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 WATERFORD PKWY STE B",
            "city": "SAINT JOHNS",
            "state": "MI",
            "postal_code": "488799631",
            "telephone_number": "989-534-2370",
            "fax_number": "989-534-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 WATERFORD PKWY STE B",
            "city": "SAINT JOHNS",
            "state": "MI",
            "postal_code": "488799631",
            "telephone_number": "989-534-2370",
            "fax_number": "989-534-2371"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "818 W King St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Owosso",
            "state": "MI",
            "postal_code": "488672117",
            "country_code": "US",
            "telephone_number": "989-723-1390",
            "fax_number": "989-725-1415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNEY",
        "first_name": "SARAH",
        "middle_name": "SUZANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-07",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704280113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710281563",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "FREY",
            "middle_name": "S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Johns, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; 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.