Bryan R Wipperman, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

01031311 Issued in IN

Practice address

416 E Monroe St
Suite 200
South Bend, IN 46601-2360

Phone

(574) 232-8119

Fax

(574) 288-0235

NPI assigned

Dec 27, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223251200000",
    "number": "1073590675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 E MONROE ST",
            "address_2": "SUITE 200",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466012360",
            "telephone_number": "574-232-8119",
            "fax_number": "574-288-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 E MONROE ST",
            "address_2": "SUITE 200",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466012360",
            "telephone_number": "574-232-8119",
            "fax_number": "574-288-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIPPERMAN",
        "first_name": "BRYAN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2008-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01031311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100089840",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheri A Wilson, PA-C
• Maxwell Lewis Winkler, M.D.
• Derrick Lamonte Winston
• Mychaela Mychelle Winston, RBT
• Heather D Winterrowd
• Vickie W Wipperman, M.D.
• Justine Wise, LCSW
• Jody Lynn Wiseman, M.D.
• Madelyn Wiseman
• Juliana M Witham, OPTICIAN

• Anesthesiology Physician in South Bend, IN
• Providers in South Bend, IN by specialty
• Anesthesiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.