Todd Christopher Space, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

4301048699 Issued in MI

Practice address

1105 Sixth St
Traverse City, MI 49684-2345

Phone

(231) 935-0497

NPI assigned

Jul 26, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

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.

• Pathology Associates of Fairfield County, LLC.

  • Anatomic Pathology & Clinical Pathology Physician
  • Lancaster, OH
  • NPI 1962054312
  NPD
• Diagnostic Pathology Associates, Inc

  • Clinical Medical Laboratory
  • Westerville, OH
  • NPI 1578532487
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1497778732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3769 COLUMBUS PIKE STE 220",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430157213",
            "telephone_number": "877-850-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842345",
            "telephone_number": "231-935-0497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPACE",
        "first_name": "TODD",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301048699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Soul Purpose Home Care, LLC
• Soul Purpose Transportation, LLC
• Southern Grand Traverse Medical
• Brandie Sowash, LLMSW
• Jennifer J. Sowle, PHD
• Kristin M Sparks, PHARMD
• Erika L Spaulding
• Mareena R Spaulding
• Mason Delores Spear
• Specialized Eye Care and Eye Wear Services, PLLC

• Diagnostic Radiology Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Diagnostic Radiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.