Individual provider Active NPI

Anthony J Hergesheimer, RN

  • Case Management Registered Nurse
  • Cadillac, MI
National Provider Identifier
1902632458
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management Registered NurseTaxonomy code 163WC0400X
License
4704415624 Issued in MI
Practice address
527 Cobb St
Cadillac, MI 49601-2540
Phone
(231) 620-7058
Fax
(231) 775-1692
NPI assigned
Sep 11, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X 4704415624 MI Primary

Addresses

Primary practice location

527 Cobb St
Cadillac, MI 49601-2540

Mailing address

527 Cobb St
Cadillac, MI 49601-2540
Phone (231) 620-7058

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704415624MIMDCase Management Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1726012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1902632458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 COBB ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012540",
            "telephone_number": "231-620-7058",
            "fax_number": "231-775-1692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 COBB ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012540",
            "telephone_number": "231-620-7058",
            "fax_number": "231-775-1692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERGESHEIMER",
        "first_name": "ANTHONY",
        "middle_name": "J",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-11",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "MI",
            "license": "4704415624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cadillac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.