Active NPI
Bradley D Riley, MD
- Medical Toxicology (Emergency Medicine) Physician
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Toxicology (Emergency Medicine) Physician
- License
- 4301078635
- Practice address
- 100 Michigan St NE
Grand Rapids, MI 49503-2560 - Phone
- (616) 391-1680
- NPI assigned
- Nov 7, 2005
- Last updated
- Feb 20, 2025
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 4301078635 | MI | |
| Emergency Medicine Physician | 207P00000X | 4301078635 | MI | |
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | 4301078635 | MI | |
| Medical Toxicology (Emergency Medicine) Physician | 207PT0002X | 4301078635 | MI | Primary |
Addresses
Primary practice location
100 Michigan St NE
Grand Rapids, MI 49503-2560
Mailing address
4100 Embassy Dr SE Ste 400
Grand Rapids, MI 49546-2416
Phone (616) 975-1845
Other practice location 1
100 Michigan St NE Ste 200
Grand Rapids, MI 49503-2560
Phone (616) 975-1845
Other practice location 2
1840 Wealthy St SE
Grand Rapids, MI 49506-2921
Phone (616) 391-1774
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00347385 | Other | MI | RAILROAD MEDICARE |
| 1912988023 | Medicaid | MI |
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32995 | AZ | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spectrum Health Primary Care Partners | Current | Accepting new patients | |
| Visionary Medical Services PC | Anesthesiology | Current | Accepting new patients |
| Cherry Street Services, Inc. | Family Medicine | Current | Accepting new patients |
| Spectrum Health Primary Care Partners | Anesthesiology | Current | Accepting new patients |
| Cherry Street Services, Inc | Current | Accepting new patients | |
| Rightcare Clinic PC | Current | Accepting new patients | |
| Ecs Western Michigan PC | Anesthesiology | Current | Accepting new patients |
| Emergency Physicians Professional Association LTD | Emergency Medicine | Past | Accepting new patients |
| Ingenuity Medical Group LLC | Emergency Medicine | Past | Accepting new patients |
| Cherry Street Services Inc | Anesthesiology | Past | Accepting new patients |
Locations
100 Cherry St SE
Grand Rapids, MI 49503
Phone (616) 965-8209
100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680
100 Michigan St NE
Ste 200
Grand Rapids, MI 49503
1840 Wealthy St SE
Grand Rapids, MI 49506
Phone (616) 391-1730
2303 Kalamazoo Ave SE
Grand Rapids, MI 49507
Phone (616) 242-6400
2303 Kalamazoo Ave SE
Ste 200
Grand Rapids, MI 49507
Phone (616) 965-8379
4100 Embassy Dr SE
Ste 400
Grand Rapids, MI 49546
Phone (616) 285-8075
550 Cherry St SE
Grand Rapids, MI 49503
Phone (616) 235-7272
743 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 456-9553
1003 N Lafayette St
Greenville, MI 48838
Phone (616) 225-9650
615 S Bower St
Greenville, MI 48838
Phone (616) 754-4341
4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600
1611 Oak Ave
Muskegon, MI 49442
Phone (231) 724-6050
Interoperability endpoints
- bradley.riley.p1@direct.cherryhealth.nextgenshare.com
Organizations & group practices 10
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.
-
dba Cherry Street Health Services
- Federally Qualified Health Center (FQHC)
- Grand Rapids, MI
- NPI 1558459164
Family Medicine
-
- Specialist
- Grand Rapids, MI
- NPI 1972372142
-
dba Corewell Health Medical Group West
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1235188673
-
- Emergency Medicine Physician
- Grand Rapids, MI
- NPI 1538216569
Anesthesiology
-
dba Cherry Health - Tri County Middle School
- Federally Qualified Health Center (FQHC)
- Howard City, MI
- NPI 1831955251
-
dba Corewell Health Medical Group West
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1689499667
Anesthesiology
-
dba Cherry Health - Southside Health Center Suite 200
- Federally Qualified Health Center (FQHC)
- Grand Rapids, MI
- NPI 1982279428
Anesthesiology
-
- Emergency Medicine Physician
- Phoenix, AZ
- NPI 1114931490
-
- Emergency Medicine Physician
- Phoenix, AZ
- NPI 1417986118
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740009600000",
"number": "1912988023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4100 EMBASSY DR SE STE 400",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495462416",
"telephone_number": "616-975-1845",
"fax_number": "616-285-0846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MICHIGAN ST NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560",
"telephone_number": "616-391-1680"
}
],
"practiceLocations": [
{
"address_1": "100 Michigan St NE Ste 200",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495032560",
"country_code": "US",
"telephone_number": "616-975-1845",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1840 Wealthy St SE",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495062921",
"country_code": "US",
"telephone_number": "616-391-1774",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RILEY",
"first_name": "BRADLEY",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-07",
"last_updated": "2025-02-20",
"certification_date": "2025-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MI",
"license": "4301078635",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MI",
"license": "4301078635",
"primary": false
},
{
"code": "207PE0004X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "MI",
"license": "4301078635",
"primary": false
},
{
"code": "207PT0002X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Medical Toxicology",
"state": "MI",
"license": "4301078635",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00347385",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1912988023",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.