BRAD JOHANNSEN (NPI# 1871008409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871008409 |
| Entity Type | Individual |
| Full Name | BRAD JOHANNSEN |
| Credential | DC |
| Practice Address |
6769 Courtland Dr Ne Ste 100 Rockford MI 49341-7243 |
| Practice Telephone | 6168639482 |
| Mailing Telephone | 6168639482 |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2017-12-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 2301010622 | MI | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 2301010622 | 05 |
| Street Address |
6769 COURTLAND DR NE STE 100 |
| City | ROCKFORD |
| State | MI |
| Zip Code | 49341-7243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801451836 | Heather Nash | Social Worker | 65 S. Main Street, Lower Level, Rockford, MI 49341 | 2019-05-06 |
| 1366967069 | Caitlin Lebron | Case Manager/Care Coordinator | 8625 Wildcat Run Dr Ne, Rockford, MI 49341 | 2017-08-03 |
| 1366967077 | Elite Nurse Staffing, LLC | Nursing Care | 3836 Windwood Drive, Ne, Rockford, MI 49341 | 2017-08-03 |
| 1336678747 | Melissa Diane Maynard | Behavior Technician | 3361 36th St., Grand Rapids, MI 49341 | 2017-06-08 |
| 1376077453 | Spectrum Health Primary Care Partners | Internal Medicine | 8501 Meadowcreek Dr, Rockford, MI 49341 | 2017-04-17 |
| 1871025254 | Robin D Dine | Behavior Technician | 8636 Shaner Ave, Rockford, MI 49341 | 2017-04-03 |
| 1528503216 | Miles Skalnek | Pharmacist | 511 10 Mile Road, Rockford, MI 49341 | 2017-01-04 |
| 1366801664 | Lorri Ann Kelbel | Massage Therapist | 11591 Northland Drive Ne, Rockford, MI 49341 | 2016-02-15 |
| 1275872046 | Eugene Louis Bonofiglo | Dentist | 4655- 14 Mile Rd Ne, Rockford, MI 49341 | 2013-02-13 |
| 1740539246 | Erica Joyce Nichols | Chiropractor | 6769 Courtland Dr, Suite 100, Rockford, MI 49341 | 2012-08-30 |
| Find all providers in zip 49341 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649886730 | Simply Wellness Chiropractic, LLC | Chiropractor | 7117 Crimson Ridge Dr Ste 1, Rockford, IL 61107-6213 | 2020-09-23 |
| 1477161966 | Trufant Chiropractic Center | Chiropractor | 11775 Cedar Rock Dr Ne Ste C, Rockford, MI 49341-8255 | 2020-07-21 |
| 1700405925 | James Robert Palmer IIi | Chiropractor | 863 S Perryville Rd, Rockford, IL 61108-4328 | 2020-04-09 |
| 1720613631 | Mario Nathaniel Rosales | Chiropractor | 818 Coolidge Pl, Rockford, IL 61107-3638 | 2020-03-11 |
| 1740840271 | Natalie Rose Richards | Chiropractor | 5875 E Riverside Blvd Ste 115, Rockford, IL 61114-4937 | 2019-06-17 |
| 1710449756 | Vitaliy Dobrogorskiy | Chiropractor | 4350 Morsay Dr, Rockford, IL 61107-4877 | 2019-04-01 |
| 1245755867 | Lynch Chiropractic | Chiropractor | 3806 E State St Ste 101, Rockford, IL 61108-2057 | 2017-08-04 |
| 1871049692 | Nicole Theresa Giacopelli | Chiropractor | 6000 E State St Ste 201, Rockford, IL 61108-2521 | 2016-08-31 |
| 1396132692 | Kb Chiropractic Center, Inc. | Chiropractor | 2606 Broadway, Suite 1a, Rockford, IL 61108-5768 | 2015-04-24 |
| 1629485040 | Nicholas A. Wells | Chiropractor | 4855 E State St Ste 24, Rockford, IL 61108-2274 | 2014-07-17 |
| Find all providers in ROCKFORD | ||||
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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.