DR. MELISSA VANDENBERG (NPI# 1093180465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1093180465 |
Entity Type | Individual |
Full Name | DR. MELISSA VANDENBERG |
Credential | PHARM.D. |
Practice Address |
5900 Byron Center Ave Sw Wyoming MI 49519-9606 |
Practice Telephone | 6162526868 |
Mailing Telephone | 6162526868 |
Enumeration Date | 2015-12-09 |
Last Update Date | 2015-12-09 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
5302034930 | MI | Pharmacy Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MI | NCPDP | 2325062 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386642148 | Melissa Bearden Vandenberg | Physician Assistant | 1855 Springhill Ave, Mobile, AL 36607-2301 | 2005-07-14 |
Street Address |
5900 BYRON CENTER AVE SW |
City | WYOMING |
State | MI |
Zip Code | 49519-9606 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760484869 | Anita Irene Charochak | Internal Medicine | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2005-06-02 |
1912504283 | Jacalyn Kaiser | Occupational Therapist | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2020-10-08 |
1659987196 | David Paul Mandziara | Specialist/Technologist, Other | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9686 | 2020-09-21 |
1265048847 | Bella Baazov | Occupational Therapist | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2020-09-19 |
1548889504 | Maurice Anthony Marshall | Student in an Organized Health Care Education/Training Program | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2020-04-10 |
1619596814 | Tyler Ledy | Student in an Organized Health Care Education/Training Program | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9686 | 2020-04-09 |
1427677475 | James Darin Chessrown | Student in an Organized Health Care Education/Training Program | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2020-04-09 |
1285263533 | Matthew Michael Gibbs | Student in an Organized Health Care Education/Training Program | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2020-04-07 |
1427687755 | Molly Magen | Student in an Organized Health Care Education/Training Program | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2020-04-07 |
1316576804 | Lindsay Grace Schichtel | Student in an Organized Health Care Education/Training Program | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2020-04-06 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609364009 | Alexandra K Hylen | Dentist | 4489 Byron Center Ave Sw Ste A, Wyoming, MI 49519 | 2018-05-01 |
1962925685 | Nicole Lee Kolasa | Rehabilitation Counselor | 2038 Melvin St. Sw, Wyoming, MI 49519 | 2017-07-25 |
1720534472 | Michael Ash | Rehabilitation Practitioner | 1870 36th Street, Wyoming, MI 49519 | 2016-08-31 |
1891248993 | Kayleigh Saucier | Family Medicine | 5900 Byron Center Avenue Se, Wyoming, MI 49519 | 2016-07-26 |
1093112799 | Wmro LLC | Radiology | 5950 Metro Way, Wyoming, MI 49519 | 2014-11-24 |
1033547658 | Maranda Catherine Gary | Nurse Practitioner | 2122 Health Drive, Wyoming, MI 49519 | 2013-10-16 |
1144657800 | Diana Ro | Psychologist | 4211 Parkway Place Sw, #100, Wyoming, MI 49519 | 2013-09-26 |
1386077873 | Lindsey Elizabeth Chorney | Nurse Practitioner | 2122 Health Drive Sw, Suite 133, Wyoming, MI 49519 | 2013-08-20 |
1124377163 | Vision and Sensory Center of Michigan LLC | Optometrist | 4467 Byron Center Ave., Wyoming, MI 49519 | 2012-09-06 |
1881940203 | Judah | Durable Medical Equipment & Medical Supplies | 2975 Waterchase Way Sw Suite 307, Wyoming, MI 49519 | 2012-08-03 |
Find all providers in zip 49519 |
Taxonomy Code | 1835P0018X |
Grouping | Pharmacy Service Providers |
Classification | Pharmacist |
Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609407543 | Debra M Lirones | Pharmacist | 2375 28th St Sw, Wyoming, MI 49519-2380 | 2020-01-29 |
1780191841 | Casey Marie Kamps | Pharmacist | 5838 Metro Way Sw, Wyoming, MI 49519-9619 | 2018-01-10 |
1891160073 | Breana Wygant | Pharmacist | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2015-12-14 |
1134407216 | Laura Constance Schuster | Pharmacist | 5838 Metro Way Sw, 119q, Wyoming, MI 49519-9619 | 2011-07-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578163069 | Alaric Michael Nielson | Pharmacist | 158 Schoolcraft St, Lake Linden, MI 49945-1328 | 2020-10-26 |
1598380529 | Daniel Asare Offei | Pharmacist | 2539 Sagewood Ave Ne Unit 718, Grand Rapids, MI 49525-2952 | 2020-06-16 |
1013540426 | Aiman Abueida | Pharmacist | 17000 Executive Plaza Dr Ste 201, Dearborn, MI 48126-2793 | 2020-02-14 |
1336770866 | Azadeh Ali Moghaddam | Pharmacist | 5951 Sunrise Dr, Ypsilanti, MI 48197-7498 | 2020-02-03 |
1811527104 | Bailey Elaine Johnson | Pharmacist | 626 W Front St, Traverse City, MI 49684-2210 | 2020-01-25 |
1588202089 | Kenneth Alexander | Pharmacist | 40339 Grand River Ave # 110, Novi, MI 48375 | 2019-12-15 |
1760020333 | Deborah Handrinos Njus | Pharmacist | 19028 Stonewater Blvd, Northville, MI 48168-8560 | 2019-12-14 |
1255978037 | Dana Trudell | Pharmacist | 829 W 4th St, Pinconning, MI 48650-8907 | 2019-11-29 |
1174169270 | Debra Joyce Lammers | Pharmacist | 531 West Main Street, Milan, MI 48160 | 2019-11-23 |
1467098533 | Thomas Aaron | Pharmacist | 4194 Glenbrook Ct, Sterling Heights, MI 48310-3378 | 2019-11-22 |
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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.