Active NPI
David William Brege, MD
- Pediatrics Physician
- Utica, MI
National Provider Identifier
1770550709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 4301051390
- Practice address
- 44720 Van Dyke Ave
Utica, MI 48317-5480 - Phone
- (586) 323-7148
- Fax
- (586) 323-7215
- NPI assigned
- Mar 8, 2006
- Last updated
- Nov 4, 2008
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4301051390 | MI | Primary |
Addresses
Primary practice location
44720 Van Dyke Ave
Utica, MI 48317-5480
Mailing address
44720 Van Dyke Ave
Utica, MI 48317-5480
Phone (586) 323-7148
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 700E012740 | Other | MI | BCBS GROUP NUMBER |
| 1770550709 | Medicaid | MI | |
| 4373558 | Medicaid | MI | |
| 0500783 | Other | MI | BCBS PIN NUMBER |
| 4519658 | Other | MI | AETNA |
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 |
|---|---|---|---|
| 4301051390 | MI | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225756800000",
"number": "1770550709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44720 VAN DYKE AVE",
"city": "UTICA",
"state": "MI",
"postal_code": "483175480",
"telephone_number": "586-323-7148",
"fax_number": "586-323-7215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44720 VAN DYKE AVE",
"city": "UTICA",
"state": "MI",
"postal_code": "483175480",
"telephone_number": "586-323-7148",
"fax_number": "586-323-7215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREGE",
"first_name": "DAVID",
"middle_name": "WILLIAM",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-08",
"last_updated": "2008-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301051390",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS GROUP NUMBER",
"identifier": "700E012740",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1770550709",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4373558",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PIN NUMBER",
"identifier": "0500783",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4519658",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Utica, MI
- Janifer Binion, M.A.
- Shauna Nina Bittou
- Laurel J. Blume, MS, LPC
- Melina A Bologna, M.A.
- Sharon Lee Boyer, LLP
- Brian J Donlon D D S P C
- Tiffany Renee Brigolin
- Brookdale Senior Living Communities, Inc. (Brookdale Utica AL)
- Brookdale Senior Living Communities, Inc. (Brookdale Utica MC)
- Frances Rose Brown, PSYD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.