BREANNA HACKWORTH (NPI# 1689201402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689201402 |
| Entity Type | Individual |
| Full Name | BREANNA HACKWORTH |
| Practice Address |
45211 Helm St Plymouth MI 48170-6023 |
| Mailing Address |
5801 S Mcclintock Dr Ste 110 Tempe AZ 85283-6002 |
| Practice Telephone | 7345259712 |
| Mailing Telephone | 4807774060 |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2020-03-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 242T00000X | Perfusionist | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
45211 HELM ST |
| City | PLYMOUTH |
| State | MI |
| Zip Code | 48170-6023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124478318 | Katharine Elisabeth Seal | Specialist/Technologist, Other | 45211 Helm St, Plymouth, MI 48170-6023 | 2016-06-17 |
| 1497356703 | Mary Dramer | Perfusionist | 45211 Helm St, Plymouth, MI 48170-6023 | 2020-11-03 |
| 1922609460 | Michael Jimenez | Perfusionist | 45211 Helm St, Plymouth, MI 48170-6023 | 2020-11-02 |
| 1245830561 | Mikaela Forkner | Perfusionist | 45211 Helm St, Plymouth, MI 48170-6023 | 2020-10-27 |
| 1205435484 | Randy Torres | Perfusionist | 45211 Helm St, Plymouth, MI 48170-6023 | 2020-10-20 |
| 1063010510 | Ashleigh Hayden | Perfusionist | 45211 Helm St, Plymouth, MI 48170-6023 | 2020-10-15 |
| 1215535760 | Michael Murphy | Specialist/Technologist, Other | 45211 Helm St, Plymouth, MI 48170-6023 | 2020-10-15 |
| 1942808936 | Nelson Tait | Perfusionist | 45211 Helm St, Plymouth, MI 48170-6023 | 2020-10-13 |
| 1750989646 | Brandon Cheney | Perfusionist | 45211 Helm St, Plymouth, MI 48170-6023 | 2020-10-13 |
| 1639776743 | Alicia M Rothert | Perfusionist | 45211 Helm St, Plymouth, MI 48170-6023 | 2020-10-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720611734 | Brightside Medical of Michigan, P.C. | Psychiatry & Neurology | Telemedicine Services Only / No Physical Office, Telemedicine Services Only / No Physical, MI 48170 | 2020-02-18 |
| 1265075279 | Mast Enterprises | Home Health | 40800 Five Mile Rd Ste C, Plymouth, MI 48170 | 2019-10-22 |
| 1003470964 | Smiley Private Homecare LLC | Technician, Pathology | 1098 Ann Arbor Rd #249, Plymouth, MI 48170 | 2019-04-26 |
| 1275003832 | Atsalis Dental Excellence | Dentist | 690 South Main St, Plymouth, MI 48170 | 2018-11-27 |
| 1275003808 | Danielle Cefalo | Speech-Language Pathologist | 801 W. Ann Arbor Trail Suite 220, Plymouth, MI 48170 | 2018-11-27 |
| 1962987966 | Mindful Wellness Counseling, LLC | Social Worker | 9266 Northern Ave, Plymouth, MI 48170 | 2018-09-26 |
| 1972094027 | Plymouth Urgent Care Walk-in Clinic LLC | Clinic/Center | 1498 S Sheldon Rd, Plymouth, MI 48170 | 2018-05-24 |
| 1356843791 | Polaris Pharmacy Services of Michigan, LLC | Pharmacy | 9131 General Court, Plymouth, MI 48170 | 2018-03-01 |
| 1528569787 | Alcona Citizens for Health Inc | Clinic/Center | 101 S Union St Unit 101, Plymouth, MI 48170 | 2018-02-23 |
| 1073029484 | Holly Ann Haase | Technician/Technologist | 650 Church St, Plymouth, MI 48170 | 2017-12-20 |
| Find all providers in zip 48170 | ||||
| Taxonomy Code | 242T00000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Perfusionist |
| A perfusionist operates extracorporeal circulation and autotransfusion equipment during any medical situation where it is necessary to support or temporarily replace the patient’s circulatory or respiratory function. The perfusionist is knowledgeable concerning the variety of equipment available to perform extracorporeal circulation functions and is responsible, in consultation with the physician, for selecting the appropriate equipment and techniques to be used. |
| Notes: Source: Health Professions Career and Education Directory, American Medical Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497356703 | Mary Dramer | Perfusionist | 45211 Helm St, Plymouth, MI 48170-6023 | 2020-11-03 |
| 1922609460 | Michael Jimenez | Perfusionist | 45211 Helm St, Plymouth, MI 48170-6023 | 2020-11-02 |
| 1245830561 | Mikaela Forkner | Perfusionist | 45211 Helm St, Plymouth, MI 48170-6023 | 2020-10-27 |
| 1205435484 | Randy Torres | Perfusionist | 45211 Helm St, Plymouth, MI 48170-6023 | 2020-10-20 |
| 1063010510 | Ashleigh Hayden | Perfusionist | 45211 Helm St, Plymouth, MI 48170-6023 | 2020-10-15 |
| 1942808936 | Nelson Tait | Perfusionist | 45211 Helm St, Plymouth, MI 48170-6023 | 2020-10-13 |
| 1750989646 | Brandon Cheney | Perfusionist | 45211 Helm St, Plymouth, MI 48170-6023 | 2020-10-13 |
| 1639776743 | Alicia M Rothert | Perfusionist | 45211 Helm St, Plymouth, MI 48170-6023 | 2020-10-02 |
| 1679189799 | Brian Carlson | Perfusionist | 45211 Helm St, Plymouth, MI 48170-6023 | 2020-09-23 |
| 1689289670 | Nichole Bernhardt | Perfusionist | 45211 Helm St, Plymouth, MI 48170-6023 | 2020-09-15 |
| Find all providers in PLYMOUTH | ||||
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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.