Katrina Ann Brummel, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601008609 Issued in MI

Practice address

555 Midtowne St NE Ste 110
Grand Rapids, MI 49503-5731

Phone

(616) 588-8880

NPI assigned

Mar 30, 2018

Last updated

Mar 30, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bradley Bengtson, M.D. PC

  dba Bengtson Center for Aesthetics and Plastic Surgery

  • Plastic Surgery Physician
  • Grand Rapids, MI
  • NPI 1013234707
  NPD (past)

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

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522368000000",
    "number": "1174029094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3974 MCINTYRE CT SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181738",
            "telephone_number": "320-310-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 MIDTOWNE ST NE STE 110",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035731",
            "telephone_number": "616-588-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMMEL",
        "first_name": "KATRINA",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-30",
        "last_updated": "2018-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna E Bruins-Campbell, MD
• Benjamin J Bruinsma, M.D.
• Chelsea Diane Bruinsma, MA
• John David Bruinsma, DDS
• Caitlin Brummel, BSW, QIDP
• Rebecca Marie Brummel, BS
• Scott R Brundage, MD
• Debra Christine Brunette, RD
• Leonard Anthony Brunette, MD
• Anne Bruni, ACNPC-AG

• Physician Assistant in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2018; 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.