Active NPI
Aubrey Kristen Tuders, PSYD
- Clinical Psychologist
- Portage, MI
National Provider Identifier
1740582857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301016914
- Practice address
- 1617 E Milham Ave
Zach Duggar
Portage, MI 49002-3049 - Phone
- (612) 300-0533
- NPI assigned
- Nov 22, 2010
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301016914 | MI | Primary |
Addresses
Primary practice location
1617 E Milham Ave
Zach Duggar
Portage, MI 49002-3049
Mailing address
1617 E Milham Ave
Zach Duggar
Portage, MI 49002-3049
Phone (612) 300-0533
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485129600000",
"number": "1740582857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1617 E MILHAM AVE",
"address_2": "ZACH DUGGAR",
"city": "PORTAGE",
"state": "MI",
"postal_code": "490023049",
"telephone_number": "612-300-0533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1617 E MILHAM AVE",
"address_2": "ZACH DUGGAR",
"city": "PORTAGE",
"state": "MI",
"postal_code": "490023049",
"telephone_number": "612-300-0533"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUDERS",
"first_name": "AUBREY",
"middle_name": "KRISTEN",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-22",
"last_updated": "2017-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301016914",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portage, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.