BRADI MICHAEL PETER KIPPER (NPI# 1184904567) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184904567 |
| Entity Type | Individual |
| Full Name | BRADI MICHAEL PETER KIPPER |
| Credential | PA-C |
| Practice Address |
2300 53rd Ave Suite 100 Bettendorf IA 52722-7564 |
| Practice Telephone | 5633220971 |
| Practice Fax Number | 5633240615 |
| Mailing Telephone | 5633220971 |
| Mailing Fax Number | 5633240615 |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2011-11-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 085004237 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363A00000X | Physician Assistant | 002217 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | MEDICARE PTAN | 578210014 | 01 |
| Street Address |
2300 53RD AVE SUITE 100 |
| City | BETTENDORF |
| State | IA |
| Zip Code | 52722-7564 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932187259 | Peter C Rink | Orthopaedic Surgery | 2300 53rd Ave, Suite 100, Bettendorf, IA 52722-7564 | 2006-01-06 |
| 1699257923 | Lauren Bethany Warner | Nurse Practitioner | 2300 53rd Ave, Bettendorf, IA 52722-7564 | 2018-09-04 |
| 1891171369 | Jessica M Mckearney | Nurse Practitioner | 2300 53rd Ave, Suite 100, Bettendorf, IA 52722-7564 | 2015-08-06 |
| 1609266295 | Rachel Paulsen | Physical Therapist | 2300 53rd Ave, Ll02, Bettendorf, IA 52722-7564 | 2015-02-03 |
| 1679976732 | Stefanie A Glider | Physician Assistant | 2300 53rd Ave, Suite 100, Bettendorf, IA 52722-7564 | 2014-10-03 |
| 1508265398 | Elizabeth Brandt | Occupational Therapist | 2300 53rd Ave, Ste. Ll02, Bettendorf, IA 52722-7564 | 2014-08-18 |
| 1588090476 | Jason Robert Ryckeghem | Physician Assistant | 2300 53rd Ave, Suite 100, Bettendorf, IA 52722-7564 | 2013-09-24 |
| 1609149368 | Kyle A Merten | Physical Therapist | 2300 53rd Ave, Suite Ll02, Bettendorf, IA 52722-7564 | 2012-02-10 |
| 1093022873 | Ryan Travis Pokorney | Orthopaedic Surgery | 2300 53rd Ave, Bettendorf, IA 52722-7564 | 2010-09-01 |
| 1710200894 | James Edward Lyles Jr. | Surgery | 2300 53rd Ave, Suite 100, Bettendorf, IA 52722-7564 | 2010-03-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770198855 | Wellspire-bettendorf LLC | Skilled Nursing Facility | 4699 53rd Ave, Bettendorf, IA 52722 | 2020-09-15 |
| 1558873315 | Erin M Kohrt | Speech-Language Pathologist | 2500 Grant Street, Bettendorf, IA 52722 | 2017-11-01 |
| 1437680295 | Holli Christine Martin | Chiropractor | 3048 Victoria St., Bettendorf, IA 52722 | 2017-03-23 |
| 1598219552 | Alyssa Renee Matz | Counselor | 2435 Kimberly Rd Ste 96, Bettendorf, IA 52722 | 2016-08-08 |
| 1144625021 | Athletico Ltd | Physical Therapist | 3252 Ridge Point, Bettendorf, IA 52722 | 2014-11-04 |
| 1609282862 | Katherine L Browne | Nurse Practitioner | 1351 Kimberly Rd Ste 100, Bettendorf, IA 52722 | 2014-07-09 |
| 1316357494 | Kayla Leigh Ehrman | Family Medicine | 2535 Maplecrest Rd Ste 16, Bettendorf, IA 52722 | 2014-04-29 |
| 1043648454 | Duane Anthony Halbur Jr. | Counselor | 2420 Salem Ct, Bettendorf, IA 52722 | 2013-10-22 |
| 1376881185 | Christopher D Murphy | Physical Therapist | 2300 53rd Ave Ll02, Bettendorf, IA 52722 | 2013-01-29 |
| 1326386574 | Kelly C Harry | Occupational Therapist | 3470 Utica Ridge Road, Suite 4, Bettendorf, IA 52722 | 2013-01-23 |
| Find all providers in zip 52722 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023624699 | Vivara Rages | Physician Assistant | 3054 Cherrywood Dr, Bettendorf, IA 52722-7550 | 2020-09-19 |
| 1134690779 | Breanna Wickett | Physician Assistant | 4480 Utica Ridge Rd Ste 1140, Bettendorf, IA 52722-1644 | 2018-12-07 |
| 1841769510 | Elizabeth Marianne Trizzino | Physician Assistant | 6415 Blackberry Ln, Bettendorf, IA 52722-6332 | 2018-11-24 |
| 1063417558 | Elizabeth A James | Physician Assistant | 3740 Utica Ridge Road, Suite B, Bettendorf, IA 52722-1624 | 2005-06-20 |
| 1528695426 | Karly Rae Dankert | Physician Assistant | 2140 53rd Ave, Bettendorf, IA 52722-6279 | 2020-03-23 |
| 1184273971 | Madelyn Nicole Kussmann | Physician Assistant | 2140 53rd Ave, Bettendorf, IA 52722-6279 | 2019-09-05 |
| 1255983813 | Whitney Hess | Physician Assistant | 2140 53rd Ave, Bettendorf, IA 52722-6279 | 2019-07-14 |
| 1437552304 | Anita Sharma | Physician Assistant | 3415 53rd Ave, Bettendorf, IA 52722-6976 | 2014-10-06 |
| 1679976732 | Stefanie A Glider | Physician Assistant | 2300 53rd Ave, Suite 100, Bettendorf, IA 52722-7564 | 2014-10-03 |
| 1598168676 | Catherine Cleveland | Physician Assistant | 4500 Utica Ridge Rd, Bettendorf, IA 52722-1626 | 2014-10-02 |
| Find all providers in BETTENDORF | ||||
| City | BETTENDORF |
| Zip Code | 52722 |
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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.