DONALD E WILLMAN (NPI# 1184641771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184641771 |
| Entity Type | Individual |
| Full Name | DONALD E WILLMAN |
| Credential | D.O. |
| Practice Address |
751 Kenmoor Avenue Se Brightwave Pain Therapy Grand Rapids MI 49546 |
| Practice Telephone | 6166085551 |
| Practice Fax Number | 6166085551 |
| Mailing Telephone | 6166085551 |
| Mailing Fax Number | 6166085551 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2019-02-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 25116-021 | WI | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 34 002975 | OH | Allopathic & Osteopathic Physicians |
| Y | 207P00000X | Emergency Medicine | 5101006554 | MI | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | OS-3647 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 3469645 | 05 | |
| MI | BLUESHIELD | DW006554 | 01 |
| MI | 3469627 | 05 | |
| MI | BCBS | 5651018 | 01 |
| MI | 1184641771 | 05 |
| Street Address |
751 KENMOOR AVENUE SE BRIGHTWAVE PAIN THERAPY |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437762986 | Amanda Mae Ostrom | Speech-Language Pathologist | 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 | 2020-08-25 |
| 1063075562 | Kelly Lynn Ibarra | Counselor | 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 | 2019-04-19 |
| 1891257036 | Jessica Matthews LLC | Counselor | 4127 Embassy Drive Se, Grand Rapids, MI 49546 | 2019-04-05 |
| 1326518531 | Neah Morgan | Technician | 4220 Burton St Se, Grand Rapids, MI 49546 | 2018-11-29 |
| 1316430267 | Michael John Benskey | Case Manager/Care Coordinator | 4065 Saladin St Se, Grand Rapids, MI 49546 | 2018-06-14 |
| 1679062772 | Smile Cascade, P.C. | Clinic/Center | 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 | 2018-05-03 |
| 1720583289 | Jeromy Krogman | Counselor | 826 Parchment Drive Se, Grand Rapids, MI 49546 | 2018-03-27 |
| 1841792660 | Affordable Hearing Clinic | Hearing Instrument Specialist | 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 | 2018-03-07 |
| 1689176133 | Kelly Pines | Physical Therapist | 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 | 2018-03-01 |
| 1467971440 | Deanna Elizabeth Saenz | Social Worker | 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 | 2017-09-12 |
| Find all providers in zip 49546 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063933745 | Sierra Debenham | Emergency Medicine | 100 Michigan Avenue, Grand Rapids, MI 49503 | 2017-07-03 |
| 1790216877 | Lauren Turco | Emergency Medicine | 100 Michigan St Ne # Mc049, Grand Rapids, MI 49503-2560 | 2017-03-21 |
| 1336592856 | Medexpress Urgent Care, PC - Michigan | Emergency Medicine | 3100 Plainfield Ave Ne, Grand Rapids, MI 49505-3261 | 2016-07-20 |
| 1083978142 | David Swenson | Emergency Medicine | 100 Michigan St Ne # Mc49, Grand Rapids, MI 49503-2560 | 2012-07-03 |
| 1144503152 | Trinh Le | Emergency Medicine | 6080 Kalamazoo Ave Se, Grand Rapids, MI 49508-7018 | 2011-09-26 |
| 1326336496 | Clint L Mckee | Emergency Medicine | 1000 Monroe Nw, Grmep, Grand Rapids, MI 49503 | 2011-07-11 |
| 1326363789 | David Beversluis | Emergency Medicine | 322 Aurora St Se, Grand Rapids, MI 49507-3124 | 2010-03-29 |
| 1669600078 | Casey Lane Crandell | Emergency Medicine | 1000 Monroe Nw, Mc-49, Grand Rapids, MI 49503 | 2009-06-24 |
| 1417119777 | Kara Beth Cardenas | Emergency Medicine | 100 Michigan St Ne # Mc-49, Grand Rapids, MI 49503-2560 | 2008-06-27 |
| 1740490200 | Michelle Lee Whitford | Emergency Medicine | 100 Michigan St Ne # Mc-71, Grand Rapids, MI 49503-2560 | 2007-05-23 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49546 |
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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.