NPIMap

Individual provider Active NPI

Bradford A. Whitmer, D.O.

  • Gastroenterology Physician
  • Saint Clair Shores, MI
National Provider Identifier
1669636965
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
5101017745 Issued in MI
Practice address
25631 Little Mack Ave Ste 205
Saint Clair Shores, MI 48081-2108
Phone
(586) 443-2930
Fax
(586) 443-2940
NPI assigned
Jul 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101017745 MI
Gastroenterology Physician 207RG0100X 5101017745 MI Primary

Addresses

Primary practice location

25631 Little Mack Ave Ste 205
Saint Clair Shores, MI 48081-2108

Mailing address

26901 Beaumont Blvd
Southfield, MI 48033-3849
Phone (947) 522-1848

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bwhitmer111635@direct.beaumont.edu

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120502000056 MI Practitioner - GastroenterologyPractitioner - Internal Medicine 1951563394 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Michigan State University College of Osteopathic Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

25631 Little Mack Ave
Suite 205
Saint Clair Shores, MI 48081-2108
Phone (586) 443-2380

28100 Grand River Ave
Farmington Hills, MI 48336-5970

468 Cadieux Rd
Grosse Pointe, MI 48230-1507
Phone (313) 473-1705

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy72
Upper gastrointestinal (GI) endoscopy for acid reflux114

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101017745MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health PC CurrentSince Jul 1, 2015 Accepting new patients
Beaumont Medical Group- Specialty Services CurrentSince Oct 25, 2021 Accepting new patients
William Beaumont Hospital Past Accepting new patients

Locations

28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320

19020 Fort St
Riverview, MI 48193
Phone (313) 362-5100

25631 Little Mack Ave
Ste 205
Saint Clair Shores, MI 48081
Phone (586) 443-2380

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

26901 Beaumont Blvd
Southfield, MI 48033
Phone (947) 522-1867

Interoperability endpoints

  • Direct secure messaging: bwhitmer111635@direct.beaumont.edu
  • Direct secure messaging: bwhitmer1261449@epic00.shdirect.org
  • Direct secure messaging: bwhitmer220779@direct.hfhs.org

Organizations & group practices 3

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 7

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

NPI Registry JSON

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1669636965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1848",
            "fax_number": "947-522-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25631 LITTLE MACK AVE STE 205",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480812108",
            "telephone_number": "586-443-2930",
            "fax_number": "586-443-2940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITMER",
        "first_name": "BRADFORD",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-15",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101017745",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "5101017745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bwhitmer111635@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "25631 Little Mack Ave Ste 205",
            "city": "Saint Clair Shores",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480812108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.