Individual provider Active NPI

Maegan Genevieve Fernelius

  • Social Worker
  • West Branch, MI
National Provider Identifier
1811688773
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
511 Griffin Rd
West Branch, MI 48661-9251
Phone
(989) 345-5540
NPI assigned
May 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

511 Griffin Rd
West Branch, MI 48661-9251

Mailing address

4046 Prior Lake Dr
West Branch, MI 48661-9175
Phone (989) 889-6942

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": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1811688773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4046 PRIOR LAKE DR",
            "city": "WEST BRANCH",
            "state": "MI",
            "postal_code": "486619175",
            "telephone_number": "989-889-6942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 GRIFFIN RD",
            "city": "WEST BRANCH",
            "state": "MI",
            "postal_code": "486619251",
            "telephone_number": "989-345-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNELIUS",
        "first_name": "MAEGAN",
        "middle_name": "GENEVIEVE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-19",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Branch, MI

Sources for this page

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