MICHAEL JOHN BRUNELL (NPI# 1407154552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1407154552 |
Entity Type | Individual |
Full Name | MICHAEL JOHN BRUNELL |
Credential | PA-C |
Practice Address |
36 Bridge Way Pascoag RI 02859-3131 |
Practice Telephone | 4015687661 |
Practice Fax Number | 4015670900 |
Mailing Telephone | 4015687661 |
Mailing Fax Number | 4015670900 |
Enumeration Date | 2011-03-14 |
Last Update Date | 2011-03-14 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PENDING | RI | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
36 BRIDGE WAY |
City | PASCOAG |
State | RI |
Zip Code | 02859-3131 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245219070 | Northwest Community Health Care | Clinic/Center | 36 Bridge Way, Pascoag, RI 02859 | 2006-01-11 |
1699311753 | Miryam Amelia Boucher | Registered Nurse | 36 Bridge Way, Pascoag, RI 02859-3131 | 2019-11-25 |
1699335059 | Jessica Wood | Specialist/Technologist | 36 Bridge Way, Pascoag, RI 02859-3131 | 2019-06-18 |
1477048098 | Ashleigh Nicole Graley | Dentist | 36 Bridge Way, Pascoag, RI 02859-3131 | 2018-06-26 |
1275032476 | Alice Mui | Registered Nurse | 36 Bridge Way, Pascoag, RI 02859-3131 | 2018-02-03 |
1942721246 | Leslie Bumpus | Dentist | 36 Bridge Way, Pascoag, RI 02859-3131 | 2017-06-28 |
1275932311 | Sarah C. Gulla | Nurse Practitioner | 36 Bridge Way, Pascoag, RI 02859-3131 | 2014-08-14 |
1194134601 | Khantil R Shah | Dentist | 36 Bridge Way, Pascoag, RI 02859-3131 | 2014-08-08 |
1235548371 | Stephanie Pinto | Nurse Practitioner | 36 Bridge Way, Pascoag, RI 02859-3131 | 2014-08-02 |
1700291861 | Kendra Crotty | Registered Nurse | 36 Bridge Way, Pascoag, RI 02859-3131 | 2014-06-27 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811397763 | Patricia Scuncio | Physical Therapy Assistant | 252 Donahue Road, Pascoag, RI 02859 | 2014-08-28 |
1134479520 | Kimberly Mary Cote | Social Worker | 2078 Wallum Lake Rd., Pascoag, RI 02859 | 2012-09-13 |
1487923793 | Northwest Community Health Care | Clinic/Center | 999 S. Main Street, Pascoag, RI 02859 | 2011-12-16 |
1730343666 | James Edward Sullivan | Counselor | 2076 Wallum Lake Rd, Pascoag, RI 02859 | 2008-07-10 |
1427243682 | Julie A. Vander Schel | Counselor | 2076 Wallum Lake Road, Pascoag, RI 02859 | 2007-09-11 |
1699985226 | Donna Watson | Counselor | 2198 Wallum Lake Rd., Pascoag, RI 02859 | 2007-05-23 |
1194817197 | Purvi Chokshi | Internal Medicine | 2090 Wallum Lake Road, Pascoag, RI 02859 | 2006-09-28 |
1659395622 | Dennis Edward Joyce | Counselor | 2198 Wallum Lake Road, Pascoag, RI 02859 | 2006-07-26 |
1427087782 | Robert James Brothers | Counselor | 2198 Wallum Lake Rd, Pascoag, RI 02859 | 2006-06-30 |
1194002972 | Northwest Community Health Care | Community/Behavioral Health | 1 High Street, Pascoag, RI 02859 | 2011-11-08 |
Find all providers in zip 02859 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285243311 | Sara Lafreniere | Physician Assistant | 18 Millers Brook Dr, Cumberland, RI 02864-6132 | 2020-07-24 |
1962962589 | Delaney Horsley | Physician Assistant | 472 W Fountain St Apt 1, Providence, RI 02903-3570 | 2019-03-20 |
1154807717 | Ocean State Primary, LLC | Physician Assistant | 300 Toll Gate Rd Ste 101b, Warwick, RI 02886-4447 | 2018-07-17 |
1447753728 | Joseph Desrosiers II | Physician Assistant | 712 Putnam Pike Unit 2, Chepachet, RI 02814-1404 | 2018-03-13 |
1346698024 | Samantha Lea Colli | Physician Assistant | 100 Dudley St Fl 3, Providence, RI 02905 | 2016-06-02 |
1285988790 | Silver Spring Health Care Management, Inc. | Physician Assistant | 70 Kenyon Ave Unit 321, Wakefield, RI 02879 | 2012-11-06 |
1275601056 | Michael Anthony Mcgourty | Physician Assistant | 93 Thames St, Newport, RI 02840-2536 | 2006-12-01 |
1629168901 | Ri Departmenf of Corrections | Physician Assistant | 39 Howard Ave, Cranston, RI 02920-3001 | 2006-10-15 |
1962598516 | Walter Deluca | Physician Assistant | 684 Warren Ave, East Providence, RI 02914-1405 | 2006-10-04 |
1225138597 | Hope Ellen Burns | Physician Assistant | 1145 Main St, Pawtucket, RI 02860-4807 | 2006-09-25 |
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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.