BRANDON D ELLSWORTH (NPI# 1689848459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689848459 |
| Entity Type | Individual |
| Full Name | BRANDON D ELLSWORTH |
| Credential | MD |
| Practice Address |
200 Jefferson Ave Se Grand Rapids MI 49503-4502 |
| Mailing Address |
Po Box 1629 Lima OH 45802-1629 |
| Practice Telephone | 6163646700 |
| Mailing Telephone | 8773784293 |
| Mailing Fax Number | 4192232726 |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2020-06-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
4301102483 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1689848459 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5900 Byron Center Ave Sw, Wyoming, MI 495199606 | 6162527166 |
| Street Address |
200 JEFFERSON AVE SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49503-4502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114929353 | Grand River Emergency Medical Group Plc | Emergency Medicine | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2005-06-01 |
| 1073130449 | Jessica Goldsworthy | Pharmacist | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-07-01 |
| 1851918551 | Lacy J Worden | Pharmacist | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-06-29 |
| 1669099560 | Kamah Ellena | Pharmacist | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-06-26 |
| 1629694344 | Yoad Yechiel Porat | Anesthesiology | 200 Jefferson Ave Se, Jefferson Suite 305, Grand Rapids, MI 49503 | 2020-06-18 |
| 1851917587 | Danuka Manupriya Ubayasena | Anesthesiology | 200 Jefferson Ave Se, Jefferson Suite 305, Grand Rapids, MI 49503 | 2020-06-18 |
| 1619593530 | Albert Dongzhou Jiao | Radiology | 200 Jefferson Ave Se, Jefferson Suite 360, Grand Rapids, MI 49503 | 2020-06-17 |
| 1548882046 | Rebecca Tourison | Registered Nurse | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-05-07 |
| 1942821079 | Breanne Nicole Ranucci | Physician Assistant | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-04-29 |
| 1750901757 | Nicholas Patrick Callahan | Registered Nurse | 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 | 2020-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496195 | Airway Oxygen, Inc. | Durable Medical Equipment & Medical Supplies | Lemmen Holton Cancer Pavilion, 145 Michigan St Ne Ste 3400, Grand Rapids, MI 49503 | 2020-10-27 |
| 1730707282 | Adriana Molina-schmuker | Counselor | 901 Eastern Avenue Ne, Grand Rapids, MI 49503 | 2020-07-10 |
| 1477176949 | Kimberly Buskirk | Specialist | 1131 Ionia Ava Nw, Grand Rapids, MI 49503 | 2020-05-19 |
| 1124647805 | Jared Host | Speech-Language Pathologist | Mercy Health Hauenstein Neuroscience Center 220 Cherry, Grand Rapids, MI 49503 | 2020-04-13 |
| 1265061378 | Heather Gladfelter | Student in an Organized Health Care Education/Training Program | 339 Barclay Ave Ne Ste 300, Grand Rapids, MI 49503 | 2020-04-02 |
| 1194368647 | Amy Jo Arends | Nurse Practitioner | 350 Lafayette S.e., Suite 301, Grand Rapids, MI 49503 | 2019-10-28 |
| 1376185199 | Beth Arce | Occupational Therapist | 245 Cherry St Se Suite 302, Grand Rapids, MI 49503 | 2019-10-14 |
| 1295387256 | Althea Ziolkowski | Licensed Practical Nurse | Salvation Army Turning Point Programs, 1215 Fulton St E, Grand Rapids, MI 49503 | 2019-07-10 |
| 1790340719 | Heather Anne Fox | Occupational Therapist | Marywood, 111 Lakeside Dr Ne, Grand Rapids, MI 49503 | 2019-05-06 |
| 1184182883 | April L Kaiserlian | Social Worker | 983 Spaulding Ave Ne, Ada, MI 49503 | 2019-03-12 |
| Find all providers in zip 49503 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538390489 | Mihaela Chiselite | Pathology | 100 Michigan St Ne # Mc056, Grand Rapids, MI 49503-2560 | 2009-07-27 |
| 1306070529 | Anita Bridget Sebastian | Pathology | 330 Barclay Ave Ne Ste 300, Grand Rapids, MI 49503 | 2009-05-04 |
| 1619024585 | William Chopp | Pathology | 35 Michigan St Ne # Mc056, Grand Rapids, MI 49503-2514 | 2007-01-04 |
| 1285618447 | Pathology Laboratory, P.C. | Pathology | 2620 Horizon Drive Se, Suite 100, Grand Rapids, MI 49546-7936 | 2005-12-01 |
| 1881012425 | Britni Rose Eva Bryant | Pathology | 35 Michigan St Ne, Grand Rapids, MI 49503-2514 | 2014-04-01 |
| 1154610913 | Frances Lucianne Rosario Quinones | Pathology | 35 Michigan St Ne, Grand Rapids, MI 49503-2514 | 2011-04-01 |
| 1023165990 | Jennifer Stumph | Pathology | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2007-01-04 |
| 1174681316 | Elizabeth Ann Steensma | Pathology | 221 Michigan St Ne Ste 400, Grand Rapids, MI 49503-2543 | 2006-12-04 |
| 1184636821 | Pathology Associates of Grand Rapids, P.C. | Pathology | 200 Jefferson Ave Se, Grand Rapids, MI 49503 | 2006-08-12 |
| 1457384687 | Linda Kozel Hegstrand | Pathology | 2426 Burton St Se, Grand Rapids, MI 49546-4898 | 2006-07-09 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49503 |
Please comment or provide details below to improve the information on BRANDON D ELLSWORTH.
| 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.