Newberg Township

Primary specialty

AmbulanceTaxonomy code 341600000X

License

141005 Issued in MI

Legal business name

NEWBERG TOWNSHIP

Practice address

11900 McKinley St
Jones, MI 49061-0257

Phone

(269) 244-8504

Fax

(269) 244-5766

NPI assigned

Jun 26, 2006

Last updated

Jun 7, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Susan Forrester

Title

Director

Phone

(269) 244-5283

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339027200000",
    "number": "1881621837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37",
            "city": "JONES",
            "state": "MI",
            "postal_code": "490610037",
            "telephone_number": "269-244-5283",
            "fax_number": "269-244-5283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 MCKINLEY ST",
            "city": "JONES",
            "state": "MI",
            "postal_code": "490610257",
            "telephone_number": "269-244-8504",
            "fax_number": "269-244-5766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWBERG TOWNSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2012-06-07",
        "status": "A",
        "authorized_official_last_name": "FORRESTER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "269-244-5283",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "MI",
            "license": "141005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2837531",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roxanne Jeanette Watts, LMFT
• Susan J White, LMFT

• Ambulance in Jones, MI
• Providers in Jones, MI by specialty
• Ambulance in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.