Organization Active NPI

Big Sky Wellness LLC

  • Clinical Social Worker
  • Midland, MI
National Provider Identifier
1780457093
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
BIG SKY WELLNESS LLC
Practice address
2706 Louanna St
Midland, MI 48640-4422
Phone
(989) 878-0255
NPI assigned
Oct 30, 2023
Last updated
Oct 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Authorized official

Name
Mrs. Martina Rose Pontious Ricards Marks, LMSW
Title
Owner
Phone
(989) 878-0255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

2706 Louanna St
Midland, MI 48640-4422

Mailing address

15 Beech St
Sanford, MI 48657-9517
Phone (989) 878-0255

National Provider Directory

National Provider Directory

Locations

2706 Louanna St
Midland, MI 48640
Phone (989) 573-0891

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1698624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698624000000",
    "number": "1780457093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 BEECH ST",
            "city": "SANFORD",
            "state": "MI",
            "postal_code": "486579517",
            "telephone_number": "989-878-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2706 LOUANNA ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486404422",
            "telephone_number": "989-878-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIG SKY WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-30",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A",
        "authorized_official_last_name": "RICARDS MARKS",
        "authorized_official_first_name": "MARTINA",
        "authorized_official_middle_name": "ROSE PONTIOUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-878-0255",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.