BRADLEY T VANASSCHE (NPI# 1497775514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497775514 |
| Entity Type | Individual |
| Full Name | BRADLEY T VANASSCHE |
| Credential | MD |
| Practice Address |
1114 Charlevoix Ave Petoskey MI 49770-9701 |
| Practice Telephone | 2314399700 |
| Practice Fax Number | 2314399709 |
| Mailing Telephone | 2314399700 |
| Mailing Fax Number | 2314399709 |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2019-10-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
4301055847 | MI | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
BV055847 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS | 300Z460020 | 01 |
| MI | 3152928 | 05 | |
| MI | RR MEDICARE PTAN | P00957391 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1501 W Chisholm St, Alpena, MI 497071401 | 4122308200 |
| Street Address |
1114 CHARLEVOIX AVE |
| City | PETOSKEY |
| State | MI |
| Zip Code | 49770-9701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770548331 | Julie M Izzard | Advanced Practice Midwife | 1114 Charlevoix Ave, Petoskey, MI 49770-9701 | 2006-04-18 |
| 1184123150 | Great Lakes Ear Nose & Throat Specialists PC | Otolaryngology | 1114 Charlevoix Ave, Petoskey, MI 49770 | 2018-02-06 |
| 1821273798 | Shannon R Bieber | Physician Assistant | 1114 Charlevoix Ave, Petoskey, MI 49770-9701 | 2008-01-09 |
| 1811924160 | Matthew L Visconti Md LLC | Radiology | 1114 Charlevoix Ave, Petoskey, MI 49770-9701 | 2006-06-26 |
| 1306883202 | Matthew L Visconti | Radiology | 1114 Charlevoix Ave, Petoskey, MI 49770-9701 | 2006-05-31 |
| 1003853144 | Mvp Imaging Plc | Radiology | 1114 Charlevoix Ave, Petoskey, MI 49770-9701 | 2006-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780231985 | Olivia Michelle Seaman | Pharmacist | 1301 U.S. 31 N. Hwy, Petoskey, MI 49770 | 2019-08-22 |
| 1649733148 | Harbor Hall, Inc. | Clinic/Center | 302 Orchard Ridge Drive, Petoskey, MI 49770 | 2019-04-11 |
| 1053802942 | Devin Hueston | Dentist | 231 State St Ste 3, Petoskey, MI 49770 | 2018-05-25 |
| 1720585037 | Jacob Kenneth Tracy | Counselor | 410 E Lake Street, Suite 100, Petoskey, MI 49770 | 2018-04-12 |
| 1013424191 | Timothy Robert La Gasse | Nurse Practitioner | 401 Connable Ave, Petoskey, MI 49770 | 2018-01-10 |
| 1609303676 | Shauna Sue Stark | Nurse Practitioner | 560 W Mitchell St Ste 505, Petoskey, MI 49770 | 2017-05-22 |
| 1053851519 | Maureen Todd | Counselor | 703 Emmet St, Petoskey, MI 49770 | 2017-03-03 |
| 1457719239 | Hufford Vision & Eye Care, PC | Optometrist | 560 West Mitchell, Suite 214, Petoskey, MI 49770 | 2016-02-08 |
| 1053779439 | Kaylyn Schiemann | Specialist/Technologist | 1980 Maxwell Rd, Petoskey, MI 49770 | 2016-02-01 |
| 1669839130 | Stieber Pediatric Dentistry Pllc | Clinic/Center | 1605 Us 131 Highway, Petoskey, MI 49770 | 2016-01-28 |
| Find all providers in zip 49770 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336626696 | Quantum Medical Radiology of California, P.C. | Radiology | 1625 Bear Creek Ln Unit O, Petoskey, MI 49770-8378 | 2018-07-19 |
| 1578529178 | Stanley R Smith | Radiology | 330 E Mitchell St, #210, Petoskey, MI 49770-2671 | 2006-04-22 |
| 1073512687 | Michael A Angileri | Radiology | 416 Connable Ave, Petoskey, MI 49770-2212 | 2005-07-15 |
| 1073950945 | Andrew Osetek | Radiology | 416 Connable Ave, Petoskey, MI 49770-2212 | 2013-05-31 |
| 1467682971 | Kimberly Sue Johnson | Radiology | 416 Connable Ave, Petoskey, MI 49770-2212 | 2009-07-17 |
| 1043446834 | Nel Rainier Go | Radiology | 416 Connable Ave, Petoskey, MI 49770-2212 | 2009-06-07 |
| 1184843781 | Michael William Kuhn | Radiology | 416 Connable Ave, Petoskey, MI 49770-2212 | 2007-04-24 |
| 1477604874 | Ryan R. Hoenicke | Radiology | 416 Connable Ave, Petoskey, MI 49770-2212 | 2007-01-15 |
| 1811924160 | Matthew L Visconti Md LLC | Radiology | 1114 Charlevoix Ave, Petoskey, MI 49770-9701 | 2006-06-26 |
| 1306883202 | Matthew L Visconti | Radiology | 1114 Charlevoix Ave, Petoskey, MI 49770-9701 | 2006-05-31 |
| Find all providers in PETOSKEY | ||||
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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.