Individual provider Active NPI

Steven W. Bremer, DPM

  • Foot & Ankle Surgery Podiatrist
  • Fort Gratiot, MI
National Provider Identifier
1578630968
Registry record updated Dec 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
5901000901 Issued in MI
Practice address
4190 24TH Ave
Suite 104
Fort Gratiot, MI 48059-3882
Phone
(810) 989-7711
Fax
(810) 987-7111
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 5901000901 MI Primary

Addresses

Primary practice location

4190 24TH Ave
Suite 104
Fort Gratiot, MI 48059-3882

Mailing address

4190 24TH Ave
Suite 104
Fort Gratiot, MI 48059-3882
Phone (810) 989-7711

Other identifiers 1

IdentifierTypeStateIssuer
5745003OtherMIBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5901000901MIMDFoot & Ankle Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230422400000",
    "number": "1578630968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 24TH AVE",
            "address_2": "SUITE 104",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593882",
            "telephone_number": "810-989-7711",
            "fax_number": "810-987-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 24TH AVE",
            "address_2": "SUITE 104",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593882",
            "telephone_number": "810-989-7711",
            "fax_number": "810-987-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREMER",
        "first_name": "STEVEN",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2008-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901000901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5745003",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gratiot, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.