Brightwave Pain Therapy, PC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

BRIGHTWAVE PAIN THERAPY, PC

Practice address

751 Kenmoor Ave SE
Grand Rapids, MI 49546-2388

Phone

(616) 608-5551

NPI assigned

Jun 14, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Donald E Willman, DO

Title

President

Phone

(616) 608-5551

Specialties & licenses 1

Addresses

Other names 1

• BrightWave Pain Therapy Doing business as

Locations

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

{
    "created_epoch": "1560470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560470400000",
    "number": "1962062703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 KENMOOR AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462388",
            "telephone_number": "616-608-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 KENMOOR AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462388",
            "telephone_number": "616-608-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTWAVE PAIN THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-14",
        "last_updated": "2019-06-14",
        "status": "A",
        "authorized_official_last_name": "WILLMAN",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-608-5551",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BrightWave Pain Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bright Life Family Chiropractic, PLLC
• Bright Side Psychology PLLC
• Victoria Bright, MD
• Brighton Hospice Grand Rapids LLC
• Brightstar of West Michigan
• Kayla Lynn Brilinski
• Barbara Rosanne Brindle, PH.D., CCC-SLP
• Olivia Bringard
• Nicole Bringer
• Cristina Lynn Brini, PA

• Pain Clinic/Center in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Pain Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.