Donald E Willman, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

5101006554 Issued in MI

Practice address

751 Kenmoor Avenue SE Brightwave Pain Therapy
Grand Rapids, MI 49546

Phone

(616) 608-5551

Fax

(616) 608-5551

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Chicago College of Osteopathy, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Theoria MedicalGroup PAC ID 5395098339, 317 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hospice of Mecosta County Hospice, Big Rapids, MI, CCN 231556
• Heartland Hospice (Grand Rapids) Hospice, Grand Rapids, MI, CCN 231582
• Munson Medical Center Hospital, Traverse City, MI, CCN 230097
• Medilodge of Leelanau Nursing home, Suttons Bay, MI, CCN 235209
• Medilodge of GTC Nursing home, Traverse City, MI, CCN 235243
• Medilodge of Traverse City Nursing home, Traverse City, MI, CCN 235336

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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

• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375
  Medicare reassignment Care Compare group NPD
• Complexcare Medical Group Midwest H PLLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1457144933
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Michigan, PLLC

  • Internal Medicine Physician
  • Adrian, MI
  • NPI 1013180181
  Medicare reassignment NPD
• Sound Inpatient Physicians-Michigan, PLLC

  • Internal Medicine Physician
  • Kalamazoo, MI
  • NPI 1093967861
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Michigan PLLC

  • Internal Medicine Physician
  • Adrian, MI
  • NPI 1033370283
  NPD
• Sound Inpatient Physicians - Michigan, PLLC

  • Hospitalist Physician
  • Escanaba, MI
  • NPI 1366768178
  NPD
• Sound Inpatient Physicians-Michigan PLLC

  • Internal Medicine Physician
  • Grayling, MI
  • NPI 1639311996
  NPD
• GTC Opco, LLC

  • Skilled Nursing Facility
  • Traverse City, MI
  • NPI 1134645419
  NPD (past)
• Leelanau Opco, LLC

  • Skilled Nursing Facility
  • Suttons Bay, MI
  • NPI 1396261681
  NPD (past)
• Samaritas

  • Skilled Nursing Facility
  • Cadillac, MI
  • NPI 1366633018
  NPD (past)
• Traverse City Opco Group, LLC

  • Skilled Nursing Facility
  • Traverse City, MI
  • NPI 1194242420
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• GTC Opco, LLC

  • Skilled Nursing Facility
  • Traverse City, MI
  • NPI 1134645419

  Nursing home

  Care Compare affiliation
• Hospice of Michigan, Inc.

  • Community Based Hospice Care Agency
  • Big Rapids, MI
  • NPI 1497790323
  Care Compare affiliation
• Leelanau Opco, LLC

  • Skilled Nursing Facility
  • Suttons Bay, MI
  • NPI 1396261681

  Nursing home

  Care Compare affiliation
• Munson Medical Center

  • General Acute Care Hospital
  • Traverse City, MI
  • NPI 1952307852
  Care Compare affiliation
• Odyssey Healthcare Holding Company

  • Community Based Hospice Care Agency
  • Grand Rapids, MI
  • NPI 1114627890
  Care Compare affiliation
• Traverse City Opco Group, LLC

  • Skilled Nursing Facility
  • Traverse City, MI
  • NPI 1194242420

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548979200000",
    "number": "1184641771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 KENMOOR AVENUE SE BRIGHTWAVE PAIN THERAPY",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49546",
            "telephone_number": "616-608-5551",
            "fax_number": "616-608-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 KENMOOR AVENUE SE BRIGHTWAVE PAIN THERAPY",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49546",
            "telephone_number": "616-608-5551",
            "fax_number": "616-608-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLMAN",
        "first_name": "DONALD",
        "middle_name": "E",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2019-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS-3647",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "25116-021",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34 002975",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101006554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3469627",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3469645",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184641771",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5651018",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD",
            "identifier": "DW006554",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Demitrius Willis
• Lukas A Willis, BCBA
• Morgan Grace Willis
• Stacey Willis
• Matthew Ishmael Willison-Beedon
• Eric Willmarth, PHD
• Cloey Willmore
• Abigayle Willock
• Willow Counseling Studio
• Willow Waters Therapy

• Emergency Medicine Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.