Active NPI
Kristi Sue Root
- Clinical Social Worker
- Tawas City, MI
National Provider Identifier
1790402139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 1199 Harris Ave
Tawas City, MI 48763-9681 - Phone
- (989) 313-7736
- NPI assigned
- Oct 26, 2022
- 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 Social Worker | 1041C0700X | MI | Primary |
Addresses
Primary practice location
1199 Harris Ave
Tawas City, MI 48763-9681
Mailing address
1199 Harris Ave
Tawas City, MI 48763-9681
Phone (989) 313-7736
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://avcmh.org |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666742400000",
"number": "1790402139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1199 HARRIS AVE",
"city": "TAWAS CITY",
"state": "MI",
"postal_code": "487639681",
"telephone_number": "989-313-7736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1199 HARRIS AVE",
"city": "TAWAS CITY",
"state": "MI",
"postal_code": "487639681",
"telephone_number": "989-313-7736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROOT",
"first_name": "KRISTI",
"middle_name": "SUE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-26",
"last_updated": "2022-10-26",
"certification_date": "2022-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://avcmh.org",
"affiliation": "N",
"address_1": "1199 Harris Ave",
"city": "Tawas City",
"state": "MI",
"country_code": "US",
"postal_code": "487639681",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Tawas City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.