Active NPI
Michael Thomas Bader, MD
- Gastroenterology Physician
- Coon Rapids, MN
National Provider Identifier
1720006422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 30340
- Practice address
- 9145 Springbrook Dr NW
Suite 200
Coon Rapids, MN 55433-5885 - Phone
- (612) 871-1145
- Fax
- (612) 870-5491
- NPI assigned
- Jul 18, 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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 30340 | MN | Primary |
Addresses
Primary practice location
9145 Springbrook Dr NW
Suite 200
Coon Rapids, MN 55433-5885
Mailing address
PO Box 14909
Minneapolis, MN 55414
Phone (612) 871-1145
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400544000000",
"number": "1720006422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 14909",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55414",
"telephone_number": "612-871-1145",
"fax_number": "612-870-5491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9145 SPRINGBROOK DR NW",
"address_2": "SUITE 200",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554335885",
"telephone_number": "612-871-1145",
"fax_number": "612-870-5491"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BADER",
"first_name": "MICHAEL",
"middle_name": "THOMAS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2014-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "MN",
"license": "30340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coon Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.