Sally Ruth Haadsma

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704163877 Issued in MI

Practice address

1216 W Broadway Ave
Muskegon, MI 49441-3528

Phone

(231) 206-3704

NPI assigned

Feb 3, 2025

Last updated

Feb 3, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Sally Ruth Andrews Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shaadsma34544@carelonhealth.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Molina Care Connections, LLC.

  dba Molina CC

  • Nurse Practitioner
  • Long Beach, CA
  • NPI 1407243223
  NPD

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

{
    "created_epoch": "1738540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1962216721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 W BROADWAY AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494413528",
            "telephone_number": "231-206-3704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 W BROADWAY AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494413528",
            "telephone_number": "231-206-3704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAADSMA",
        "first_name": "SALLY",
        "middle_name": "RUTH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704163877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SALLY",
            "last_name": "ANDREWS",
            "middle_name": "RUTH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Louise Gustafson-Stephenson, LCSW
• Deb Gustafson, RPH
• Keiarra Guy, FNP
• Adam Russell Gwizdala, DO, PHARM.D.
• Ryan Gzym, PA-C
• Jennifer Haak
• Lindsey Haan, LLMSW
• Tamara Jean Haase
• Lisa Hackbarth
• Keenan L Hacker, DO

• Family Nurse Practitioner in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.