MS. SHERENDA NICOLE FAUSNAUGH (NPI# 1932479920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932479920 |
| Entity Type | Individual |
| Full Name | MS. SHERENDA NICOLE FAUSNAUGH |
| Credential | IDMT |
| Practice Address |
5195 S 148th Ave Hesperia MI 49421-9546 |
| Mailing Address |
Psc 80 Box 22495 Apo AP 96367-0109 |
| Practice Telephone | 3132583114 |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2013-03-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1003X |
Military Health Care Provider Specialization: Independent Duty Medical Technicians |
Other Service Providers |
| Street Address |
5195 S 148TH AVE |
| City | HESPERIA |
| State | MI |
| Zip Code | 49421-9546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356551832 | Pine Medical Group, PC | Surgery | 78 N Division Ave, Hesperia, MI 49421 | 2007-05-23 |
| 1518060169 | Myrtle Mclain | Family Medicine | 78 N Division, Hesperia, MI 49421 | 2006-09-07 |
| 1063535805 | Hesperia Medical Center | Family Medicine | 78 N Division, Hesperia, MI 49421 | 2007-04-09 |
| 1346546637 | Hesperia Eyecare LLC | Optometrist | 38 N Division St, Hesperia, MI 49421-5100 | 2011-02-03 |
| 1043220809 | Mollie T Hudson | Nurse Practitioner | 78 N Division St, Hesperia, MI 49421-5100 | 2006-08-08 |
| 1730642794 | Memorial Medical Center of West Michigan | Clinic/Center | 78 N Division St, Hesperia, MI 49421-5100 | 2019-04-08 |
| 1679908552 | Angela Michelle Hannah | Physician Assistant | 78 N Division St, Hesperia, MI 49421-5100 | 2013-09-10 |
| 1396878773 | Newaygo County General Hospital Association | Clinic/Center | 78 N Division St, Hesperia, MI 49421-5100 | 2007-03-14 |
| 1215045661 | Jeffrey Allen Thome | Family Medicine | 78 N Division St, Hesperia, MI 49421-5100 | 2006-08-27 |
| 1801955166 | Bob's Drug LLC | Pharmacy | 194 N Division Ave, Hesperia, MI 49421-7500 | 2006-12-06 |
| Find all providers in zip 49421 | ||||
| Taxonomy Code | 1710I1003X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Medical Technicians |
| An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians. |
| Notes: Source: Air Force Surgeon General Office [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649632944 | Amanda Marie Bean | Military Health Care Provider | 75 Phantom Ave, Battle Creek, MI 49037 | 2016-03-25 |
| 1558700971 | Billy Ray Fields Jr. | Military Health Care Provider | 6501 Us 23 South, Ossineke, MI 49766-9611 | 2013-06-19 |
| 1851588982 | Brian M Crissman | Military Health Care Provider | 5884 A St, Alpena, MI 49707-8172 | 2007-10-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.