Active NPI
Sue Augustus
- Registered Nurse
- Portage, MI
National Provider Identifier
1972955243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 4704211122
- Practice address
- 9616 Portage Rd
Portage, MI 49002-7257 - Phone
- (269) 250-8200
- Fax
- (269) 250-8339
- NPI assigned
- Jul 11, 2016
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 4704211122 | MI | Primary |
Addresses
Primary practice location
9616 Portage Rd
Portage, MI 49002-7257
Mailing address
9616 Portage Rd
Portage, MI 49002-7257
Phone (269) 250-8200
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704211122 | MI | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Residential Opportunities, Inc. | Past | Accepting new patients | |
| Residential Opportunities, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Developmental Disabilities Clinic/Center
- Portage, MI
- NPI 1538674676
-
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Kalamazoo, MI
- NPI 1750459772
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468195200000",
"number": "1972955243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9616 PORTAGE RD",
"city": "PORTAGE",
"state": "MI",
"postal_code": "490027257",
"telephone_number": "269-250-8200",
"fax_number": "269-250-8339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9616 PORTAGE RD",
"city": "PORTAGE",
"state": "MI",
"postal_code": "490027257",
"telephone_number": "269-250-8200",
"fax_number": "269-250-8339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUGUSTUS",
"first_name": "SUE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-11",
"last_updated": "2016-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MI",
"license": "4704211122",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portage, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.