Individual provider Active NPI

Bradley D Riley, MD

  • Medical Toxicology (Emergency Medicine) Physician
  • Grand Rapids, MI
National Provider Identifier
1912988023
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Toxicology (Emergency Medicine) PhysicianTaxonomy code 207PT0002X
License
4301078635 Issued in MI
Practice address
100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone
(616) 391-1680
NPI assigned
Nov 7, 2005
Last updated
Feb 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
P00347385OtherMIRAILROAD MEDICARE
1912988023MedicaidMI

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040205001199 MI Practitioner - Addiction MedicinePractitioner - AnesthesiologyPractitioner - Emergency Medicine 4880587500 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32995AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Mar 8, 2021 Accepting new patients
Visionary Medical Services PC Anesthesiology CurrentSince Jan 1, 2007 Accepting new patients
Cherry Street Services, Inc. Family Medicine CurrentSince May 6, 2019 Accepting new patients
Spectrum Health Primary Care Partners Anesthesiology CurrentSince Mar 8, 2021 Accepting new patients
Cherry Street Services, Inc CurrentSince May 6, 2019 Accepting new patients
Rightcare Clinic PC CurrentSince Oct 1, 2024 Accepting new patients
Ecs Western Michigan PC Anesthesiology CurrentSince Aug 5, 2018 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 PastSince Jun 22, 2021 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.