NPIMap

Individual provider Active NPI

Donald Wolfram, M.D.

  • Family Medicine Physician
  • Bridgman, MI
National Provider Identifier
1669499257
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301082038 Issued in MI
Practice address
9625 Red Arrow Hwy
Bridgman, MI 49106-9559
Phone
(269) 465-6050
Fax
(269) 465-3134
NPI assigned
Jul 17, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01041640A IN
Emergency Medicine Physician 207P00000X 4301082038 MI
Family Medicine Physician 207Q00000X 4301082038 MI Primary

Addresses

Primary practice location

9625 Red Arrow Hwy
Bridgman, MI 49106-9559

Mailing address

9625 Red Arrow Hwy
Bridgman, MI 49106-9559
Phone (269) 465-6050

Other practice location 1

1007 Lincolnway
LA Porte, IN 46350-3201
Phone (219) 326-1234

Other practice location 2

5515 Cleveland Ave Ste 5
Stevensville, MI 49127-9670
Phone (269) 429-9644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070314000177 IN Practitioner - Family PracticePractitioner - Emergency Medicine 7113020009 Reassigns benefits to 5 organizations
I20180320001080 MI Practitioner - Family Practice 7113020009 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kansas School of Med (KC/Wich/Sal), 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eventus Ecs, IncGroup PAC ID 2163969650, 243 clinicians

Practice addresses (Care Compare)

150 W Market St
Suite 400
Indianapolis, IN 46204-2810
Phone (855) 743-2247

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01041640AINMDEmergency Medicine Physician
4301082038MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eventus Ecs, Inc Family Medicine CurrentSince Dec 19, 2024 Accepting new patients
Extended Care Specialists, Inc Family Medicine CurrentSince Jan 29, 2024 Accepting new patients
Eventus Wholehealth Midwest Inc Family Medicine CurrentSince Jan 29, 2024 Accepting new patients
Eventus Ecs - Kentucky, PLLC CurrentSince Nov 1, 2025 Accepting new patients
Lakeland Medical Practices CurrentSince Feb 14, 2018 Accepting new patients
Lakeland Medical Practices CurrentSince Feb 14, 2018 Accepting new patients
Eventus WH Midwest Care, LLC Family Medicine CurrentSince Dec 16, 2024 Accepting new patients
Hospice at Home, Inc. Family Medicine CurrentSince Sep 5, 2022 Accepting new patients
Mercy Memorial Health Services Inc Past Accepting new patients
Maple City Emergency Physicians, LLP Emergency Medicine Past Accepting new patients
Niles Mi Opco LLC Past Accepting new patients
Cliffside Company L L C Past Accepting new patients

Locations

2100 Midway St
Columbus, IN 47201
Phone 3178181240225

3512 Stellhorn Rd
Fort Wayne, IN 46815
Phone 260483908122

150 W Market St
Ste 400
Indianapolis, IN 46204

3815 River Crossing Pkwy
Ste 100
Indianapolis, IN 46240
Phone (317) 566-2035

8398 Mississippi St
Fl 2
Merrillville, IN 46410

9625 Red Arrow Hwy
Bridgman, MI 49106
Phone (269) 465-6050

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

4025 Health Park Ln
Saint Joseph, MI 49085
Phone (269) 429-7100

5515 Cleveland Ave
Ste 5
Stevensville, MI 49127
Phone (269) 429-9644

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Cardinal Nursing and Rehabilitation CenterSouth Bend, IN, CCN 155115 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 1, 2025
Mar 23, 2026
Arbor Grove VillageGreensburg, IN, CCN 155625 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 1, 2026
May 26, 2026
Hickory Creek at GreensburgGreensburg, IN, CCN 155353 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 1, 2026
May 26, 2026
Creekside VillageMishawaka, IN, CCN 155784 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Nov 11, 2024
Mar 30, 2026

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 12

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

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1669499257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9625 RED ARROW HWY",
            "city": "BRIDGMAN",
            "state": "MI",
            "postal_code": "491069559",
            "telephone_number": "269-465-6050",
            "fax_number": "269-465-3134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9625 RED ARROW HWY",
            "city": "BRIDGMAN",
            "state": "MI",
            "postal_code": "491069559",
            "telephone_number": "269-465-6050",
            "fax_number": "269-465-3134"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1007 Lincolnway",
            "address_purpose": "LOCATION",
            "city": "LA Porte",
            "state": "IN",
            "postal_code": "463503201",
            "country_code": "US",
            "telephone_number": "219-326-1234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5515 Cleveland Ave Ste 5",
            "address_purpose": "LOCATION",
            "city": "Stevensville",
            "state": "MI",
            "postal_code": "491279670",
            "country_code": "US",
            "telephone_number": "269-429-9644",
            "fax_number": "269-429-4002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLFRAM",
        "first_name": "DONALD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01041640A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301082038",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301082038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgman, MI

Sources for this page

Verify at the official NPI Registry.