Active NPI
Robert E Brammer, MD
- Otology & Neurotology Physician
- Saint Clair Shores, MI
National Provider Identifier
1659464782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otology & Neurotology Physician
- License
- RB041151
- Practice address
- 21000 E 12 Mile Rd
Suite 111
Saint Clair Shores, MI 48081-1116 - Phone
- (586) 779-7610
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otology & Neurotology Physician | 207YX0901X | RB041151 | MI | Primary |
Addresses
Primary practice location
21000 E 12 Mile Rd
Suite 111
Saint Clair Shores, MI 48081-1116
Mailing address
21000 E 12 Mile Rd
Ste 111
St Clair Shores, MI 48081
Phone (586) 779-7610
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101300 | Other | CARE CHOICES | |
| 1886647001 | Other | CIGNA | |
| 103636 | Other | GREAT LAKES HEALTH | |
| 2968201 | Medicaid | MI | |
| 4243097 | Other | AETNA | |
| F50680 | Other | HEALTH ALLIANCE PLAN | |
| C4728 | Other | MCARE | |
| 0405041562 | Other | MI | BLUE CROSS BLUE SHIELD |
| 79301 | Other | BLUE CARE NETWORK |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RB041151 | MI | MD | Otology & Neurotology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191888000000",
"number": "1659464782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21000 E 12 MILE RD",
"address_2": "STE 111",
"city": "ST CLAIR SHORES",
"state": "MI",
"postal_code": "48081",
"telephone_number": "586-779-7610",
"fax_number": "586-445-2523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21000 E 12 MILE RD",
"address_2": "SUITE 111",
"city": "SAINT CLAIR SHORES",
"state": "MI",
"postal_code": "480811116",
"telephone_number": "586-779-7610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAMMER",
"first_name": "ROBERT",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2007-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "207YX0901X",
"taxonomy_group": "",
"desc": "Otolaryngology, Otology & Neurotology",
"state": "MI",
"license": "RB041151",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE CHOICES",
"identifier": "101300",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1886647001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREAT LAKES HEALTH",
"identifier": "103636",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2968201",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4243097",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ALLIANCE PLAN",
"identifier": "F50680",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCARE",
"identifier": "C4728",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0405041562",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARE NETWORK",
"identifier": "79301",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Clair Shores, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.