Individual provider Active NPI

Bruce Daman, NP

  • Family Nurse Practitioner
  • Grayling, MI
National Provider Identifier
1780191478
Registry record updated Jan 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704227388 Issued in MI
Practice address
1100 E Michigan Ave
Grayling, MI 49738-1312
Phone
(989) 348-5461
NPI assigned
Jan 4, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704227388 MI Primary

Addresses

Primary practice location

1100 E Michigan Ave
Grayling, MI 49738-1312

Mailing address

8691 N Sharon Rd SE
Fife Lake, MI 49633-8099
Phone (517) 525-3687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180420001347 MI Practitioner - Nurse Practitioner 8426311655 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kalkaska Memorial Health Center CurrentSince Mar 19, 2019 Accepting new patients
Kalkaska Memorial Health Center Family Current Accepting new patients
Munson Healthcare Cadillac CurrentSince Jul 9, 2018 Accepting new patients
Munson Healthcare Cadillac Current Accepting new patients
Kalkaska Memorial Health Center Nurse Practitioner CurrentSince Mar 19, 2019 Accepting new patients
Munson Healthcare Cadillac CurrentSince Jul 9, 2018 Accepting new patients
Kalkaska Memorial Health Center Nurse Practitioner Past Accepting new patients

Locations

2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031

3782 Momentum Pl
Chicago, IL 60689

400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200

302 Hobart St
Cadillac, MI 49601
Phone (231) 876-2644

1100 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0317

419 S Coral St
Kalkaska, MI 49646
Phone (231) 258-7500

1110 Sixth St
Traverse City, MI 49684
Phone (231) 392-8400

Interoperability endpoints

  • Direct secure messaging: bdaman@direct.mhc.net

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515024000000",
    "number": "1780191478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8691 N SHARON RD SE",
            "city": "FIFE LAKE",
            "state": "MI",
            "postal_code": "496338099",
            "telephone_number": "517-525-3687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E MICHIGAN AVE",
            "city": "GRAYLING",
            "state": "MI",
            "postal_code": "497381312",
            "telephone_number": "989-348-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMAN",
        "first_name": "BRUCE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-04",
        "last_updated": "2018-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704227388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayling, MI

Sources for this page

Verify at the official NPI Registry.