DR. TODD SUPER (NPI# 1053729269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053729269 |
| Entity Type | Individual |
| Full Name | DR. TODD SUPER |
| Credential | PHARM.D., BCPS |
| Practice Address |
451 Health Pkwy Paw Paw MI 49079 |
| Mailing Address |
451 Health Pkwy Ste F Paw Paw MI 49079-8242 |
| Practice Telephone | 2696551735 |
| Mailing Telephone | 2696551735 |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2018-07-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 5302036387 | MI | Pharmacy Service Providers |
| N | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
5302036387 | MI | Pharmacy Service Providers |
| Y | 1835P2201X |
Pharmacist Specialization: Ambulatory Care |
5302036387 | MI | Pharmacy Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 300 North Ave, Battle Creek, MI 490173307 | 1269245852 |
| Street Address |
451 HEALTH PKWY |
| City | PAW PAW |
| State | MI |
| Zip Code | 49079 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033115183 | Pamela Nelson | Family Medicine | 451 Health Pkwy, Suite B, Paw Paw, MI 49079-8242 | 2005-06-23 |
| 1972132256 | Jean Marie Brosnan | Registered Nurse | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2020-04-07 |
| 1114570801 | Kinju Dudhia | Physical Therapist | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2019-07-22 |
| 1235781345 | Marlesa Maria Johnson | Physical Therapist | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2019-07-10 |
| 1447802459 | Miranda Novak | Physical Therapist | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2019-07-10 |
| 1336709500 | Daniel E Laird | Physical Therapist | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2019-06-19 |
| 1932625043 | Debra Lynn Koning | Social Worker | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2017-08-21 |
| 1720439979 | Kimberly Baker | Social Worker | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2016-06-29 |
| 1467858118 | Sara Bailey | Nurse Practitioner | 451 Health Pkwy, Suite A, Paw Paw, MI 49079-8242 | 2014-11-07 |
| 1275959744 | Ashley Nichols | Occupational Therapist | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2014-03-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700359387 | Elizabeth Ann Heskett | Social Worker | Bronson Lakeview Family Care, 451 Health Parkway, Suite B, Paw Paw, MI 49079 | 2019-01-07 |
| 1346775269 | Timothy Adli Kanaan | Counselor | 816 E Michigan Ave Ste 103, Paw Paw, MI 49079 | 2017-04-28 |
| 1558655464 | Tamayi Bwititi | Family Medicine | 451 Health Pkwy Ste G, Paw Paw, MI 49079 | 2011-06-08 |
| 1942401047 | Jenny Adina Grunberg | Dentist | 54055 County Rd 653, Paw Paw, MI 49079 | 2007-05-29 |
| 1912058918 | David James Potts | Psychologist | 181 West Michigan Ave Suite 3, Mapleview Consultation Center P.c, Paw Paw, MI 49079 | 2007-01-16 |
| 1760438378 | Starhealth Multi-specialty Group, P.C. Pharmacy | Pharmacist | 451 Health Parkway, Paw Paw, MI 49079 | 2006-05-25 |
| 1528029568 | Jayantilal J Bathani | Pediatrics | 505 Hazen St, Ste 203, Paw Paw, MI 49079 | 2006-03-29 |
| 1548231202 | Gregory Cassidy | Physician Assistant | 125 N Kalamazoo St, #82, Paw Paw, MI 49079 | 2006-01-31 |
| 1649782418 | Amber Bemis | Occupational Therapy Assistant | 801 Hazen Street, Suite C, Paw Paw, MI 49079 | 2017-11-01 |
| 1073047122 | Theresa Arnold | Social Worker | 181 W Michigan Ave Ste 3, Paw Paw, MI 49079 | 2017-04-15 |
| Find all providers in zip 49079 | ||||
| Taxonomy Code | 1835P2201X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Ambulatory Care |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in the provision of integrated, accessible health care services by pharmacists and is accountable for addressing medication needs, developing sustained partnerships with patients, and practicing in the context of family and community. |
| Notes: Source: Board of Pharmacy Specialties, www.bpsweb.org [7/1/2015: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740806298 | Kathleen Hannah | Pharmacist | 271 N Groesbeck Hwy, Mount Clemens, MI 48043-1546 | 2020-06-21 |
| 1043868409 | Krishna Shankar Rangarajan | Pharmacist | 32 Cloveridge Dr, Troy, MI 48084-5411 | 2019-08-29 |
| 1447716014 | Helen Berlie | Pharmacist | 7633 E Jefferson Ave Ste 340, Detroit, MI 48214-3732 | 2019-02-19 |
| 1316417553 | Bethany Lynn Muma | Pharmacist | 2900 Watkins Rd, Battle Creek, MI 49015-8604 | 2018-11-30 |
| 1598272627 | Erika Perpich | Pharmacist | 33300 Five Mile Rd Ste 210, Livonia, MI 48154-3077 | 2018-01-10 |
| 1518491505 | Jennifer Leanne Grando | Pharmacist | 26375 Halsted Rd Apt 101, Farmington Hills, MI 48331-3743 | 2017-04-17 |
| 1467984567 | Susan Arens | Pharmacist | 3544 Meridian Crossings Ste 120, Okemos, MI 48864-4589 | 2017-03-29 |
| 1346607850 | Annaliese Brindley | Pharmacist | 29200 Northwestern Hwy Ste 325, Southfield, MI 48034-1061 | 2016-01-28 |
| 1851991418 | John M Leach | Pharmacist | 555 E Genesee St, Lapeer, MI 48446-4611 | 2020-10-31 |
| 1538778881 | Ryan M Lalonde | Pharmacist | 4401 Campus Ridge Dr Ste 1100, Midland, MI 48640-6125 | 2020-07-23 |
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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.