Individual provider Active NPI

Vanessa Vivian Calabria, DO

  • Emergency Medicine Physician
  • Adrian, MI
National Provider Identifier
1972916559
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101021264 Issued in MI
Practice address
818 Riverside Ave
Adrian, MI 49221-1446
Phone
(517) 265-0900
NPI assigned
Jun 11, 2014
Last updated
Dec 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101021264 MI Primary
Emergency Medicine Physician 207P00000X 02007549A IN

Addresses

Primary practice location

818 Riverside Ave
Adrian, MI 49221-1446

Mailing address

818 Riverside Ave
Adrian, MI 49221-1446
Phone (517) 265-0900

Other practice location 1

500 E Pottawatamie St
Tecumseh, MI 49286-2018
Phone (517) 424-3000

Other identifiers 2

IdentifierTypeStateIssuer
5101021264OtherMIPHYSICIAN LICENSE
5315066355OtherMICONTROLLED SUBSTANCE LICENSE

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
I20191002000792 MI Practitioner - Emergency Medicine 0840410924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Touro Un Col of Osteopathic Medicine, New York, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1721 S Stephenson Ave
Iron Mountain, MI 49801-3637
Phone (906) 774-1313

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dickinson County Healthcare System Student in an Organized Health Care Education/Training Program CurrentSince Mar 8, 2024 Accepting new patients

Locations

1721 S Stephenson Ave
Iron Mountain, MI 49801
Phone (906) 776-5415

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1972916559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 RIVERSIDE AVE",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211446",
            "telephone_number": "517-265-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 RIVERSIDE AVE",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211446",
            "telephone_number": "517-265-0900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 E Pottawatamie St",
            "address_purpose": "LOCATION",
            "city": "Tecumseh",
            "state": "MI",
            "postal_code": "492862018",
            "country_code": "US",
            "telephone_number": "517-424-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALABRIA",
        "first_name": "VANESSA",
        "middle_name": "VIVIAN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-11",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101021264",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "02007549A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE",
            "identifier": "5101021264",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE LICENSE",
            "identifier": "5315066355",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Adrian, MI

Sources for this page

Verify at the official NPI Registry.