Bryan Blattert

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6802090077 Issued in MI

Practice address

1199 Harris Ave
Tawas City, MI 48763-9681

Phone

(198) 936-2863

Fax

(989) 326-8636

NPI assigned

Oct 11, 2018

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

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Arrowhead Behavioral Health LLC

  • Clinical Social Worker
  • Fowlerville, MI
  • NPI 1235709098
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1539216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1396210753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1199 HARRIS AVE",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487639681",
            "telephone_number": "198-936-2863",
            "fax_number": "989-326-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 HARRIS AVE",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487639681",
            "telephone_number": "198-936-2863",
            "fax_number": "989-326-8636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLATTERT",
        "first_name": "BRYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-11",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6802090077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jayna Lynnae Ayres, NURSE PRACTITIONER
• David L Beck, LPC
• Lyn M Behnke, DNP
• Barbara Lynette Berg
• Cheryl Ann Birkenbach, RN
• John P Blocksom, D.O.
• Julie Blust
• Abigail Lynn Boensch, PT, DPT
• Gregory A Bohn, MD
• Courtney Marie Bolen, D.C

• Clinical Social Worker in Tawas City, MI
• Providers in Tawas City, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.