JOSHUA SUDERMAN (NPI# 1508092164) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508092164 |
| Entity Type | Individual |
| Full Name | JOSHUA SUDERMAN |
| Credential | MD |
| Practice Address |
710 Kenmoor Ave Se Suite 200 Grand Rapids MI 49546-2379 |
| Practice Telephone | 6165887246 |
| Practice Fax Number | 6165887086 |
| Mailing Telephone | 6165887246 |
| Mailing Fax Number | 6165887086 |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2014-07-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
4301094046 | MI | Allopathic & Osteopathic Physicians |
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
4301094046 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
710 KENMOOR AVE SE SUITE 200 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49546-2379 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235138397 | Martin J Bury | Specialist | 710 Kenmoor Ave Se, Suite 100, Grand Rapids, MI 49546-2379 | 2005-07-20 |
| 1356777098 | Abby Alysse Gaskell | Physician Assistant | 710 Kenmoor Ave Se, Ste. 100, Grand Rapids, MI 49546-2302 | 2013-09-25 |
| 1992142624 | Jeremy Robert Veenema | Pediatrics | 710 Kenmoor Ave Se, Suite 110, Grand Rapids, MI 49546-2379 | 2013-06-04 |
| 1164785887 | Ann Carol Swagman | Registered Nurse | 710 Kenmoor Ave Se, Suite 110, Grand Rapids, MI 49546 | 2012-06-18 |
| 1124332606 | Intervention Insights Inc. | Clinic/Center | 710 Kenmoor Ave Se, Ste 120, Grand Rapids, MI 49546-2379 | 2010-07-27 |
| 1033442231 | Christopher Ross Russo | Anesthesiology | 710 Kenmoor Ave Se, Suite 200, Grand Rapids, MI 49546-2379 | 2009-09-08 |
| 1164664082 | Javery Pain Institute PC | Pain Medicine | 710 Kenmoor Ave Se, Suite 200, Grand Rapids, MI 49546-2379 | 2009-03-25 |
| 1154509768 | Linda Lou Feighner | Nurse Practitioner | 710 Kenmoor Ave Se, Suite 110, Grand Rapids, MI 49546-2379 | 2008-02-06 |
| 1932227915 | Western Michigan Pediatrics, PC | Pediatrics | 710 Kenmoor Ave Se, Suite 110, Grand Rapids, MI 49546-2379 | 2007-03-27 |
| 1871632323 | Ruth Ann Brintnall | Nurse Practitioner | 710 Kenmoor Ave Se, Suite 200, Grand Rapids, MI 49546-2379 | 2007-02-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437762986 | Amanda Mae Ostrom | Speech-Language Pathologist | 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 | 2020-08-25 |
| 1063075562 | Kelly Lynn Ibarra | Counselor | 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 | 2019-04-19 |
| 1891257036 | Jessica Matthews LLC | Counselor | 4127 Embassy Drive Se, Grand Rapids, MI 49546 | 2019-04-05 |
| 1326518531 | Neah Morgan | Technician | 4220 Burton St Se, Grand Rapids, MI 49546 | 2018-11-29 |
| 1316430267 | Michael John Benskey | Case Manager/Care Coordinator | 4065 Saladin St Se, Grand Rapids, MI 49546 | 2018-06-14 |
| 1679062772 | Smile Cascade, P.C. | Clinic/Center | 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 | 2018-05-03 |
| 1720583289 | Jeromy Krogman | Counselor | 826 Parchment Drive Se, Grand Rapids, MI 49546 | 2018-03-27 |
| 1841792660 | Affordable Hearing Clinic | Hearing Instrument Specialist | 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 | 2018-03-07 |
| 1689176133 | Kelly Pines | Physical Therapist | 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 | 2018-03-01 |
| 1467971440 | Deanna Elizabeth Saenz | Social Worker | 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 | 2017-09-12 |
| Find all providers in zip 49546 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164664082 | Javery Pain Institute PC | Pain Medicine | 710 Kenmoor Ave Se, Suite 200, Grand Rapids, MI 49546-2379 | 2009-03-25 |
| 1134186513 | Bennett L Willard | Pain Medicine | 4100 Lake Dr Se, Suite 305, Grand Rapids, MI 49546 | 2006-04-28 |
| 1306803010 | Daniel Mark Mankoff | Pain Medicine | 4100 Lake Dr Se, Suite 305, Grand Rapids, MI 49546 | 2006-04-27 |
| 1376509158 | Stephen Lee Winston | Pain Medicine | 4100 Lake Dr Se, Suite 305, Grand Rapids, MI 49546 | 2006-04-21 |
| 1457315095 | Joseph Yared Vanden Bosch | Pain Medicine | 4100 Lake Dr Se, Suite 305, Grand Rapids, MI 49546 | 2006-04-12 |
| 1619930575 | Thomas Michael Basch | Pain Medicine | 4100 Lake Dr Se, Ste 305, Grand Rapids, MI 49546 | 2006-04-10 |
| 1619938545 | Mark Louis Gostine | Pain Medicine | 2060 E Paris Ave Se, Suite 200, Grand Rapids, MI 49546-6113 | 2006-03-30 |
| 1144281080 | Kevin Edward Fitzgerald | Pain Medicine | 4100 Lake Dr Se, Ste 305, Grand Rapids, MI 49546 | 2006-03-30 |
| 1225099161 | Fred Neal Davis | Pain Medicine | 2060 E Paris Ave Se, Suite 200, Grand Rapids, MI 49546-6113 | 2006-03-30 |
| 1225007206 | Scott Howard Greenwald | Pain Medicine | 4100 Lake Dr Se, Suite 305, Grand Rapids, MI 49546 | 2006-03-14 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49546 |
Please comment or provide details below to improve the information on JOSHUA SUDERMAN.
| 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.