DR. JAMES STATHAKIOS JR. (NPI# 1053351247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053351247 |
| Entity Type | Individual |
| Full Name | DR. JAMES STATHAKIOS JR. |
| Credential | M.D. |
| Practice Address |
3400 Fleckenstein Rd Suite 1 Flint MI 48507-3042 |
| Practice Telephone | 8108777370 |
| Practice Fax Number | 8102309338 |
| Mailing Telephone | 8108777370 |
| Mailing Fax Number | 8102309338 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2014-11-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 4301063353 | MI | Other Service Providers |
| N | 208100000X | Physical Medicine & Rehabilitation | 4301063353 | MI | Allopathic & Osteopathic Physicians |
| N | 225400000X | Rehabilitation Practitioner | JS063353 | MI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 103517420 | 05 |
| Street Address |
3400 FLECKENSTEIN RD SUITE 1 |
| City | FLINT |
| State | MI |
| Zip Code | 48507-3042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083688725 | Kazem Hak | Internal Medicine | 3400 Fleckenstein Rd, Suite 3, Flint, MI 48507-3043 | 2006-02-16 |
| 1730731829 | Jessica Renee Samuelson | Nurse Practitioner | 3400 Fleckenstein Rd, Flint, MI 48507-3042 | 2019-07-10 |
| 1538606546 | Dayna Rae-edgerton Timmreck | Nurse Practitioner | 3400 Fleckenstein Rd, Flint, MI 48507-3042 | 2017-01-28 |
| 1811386527 | Evolution Imaging | Radiology | 3400 Fleckenstein Rd, Suite C, Flint, MI 48507-3042 | 2015-01-19 |
| 1114328861 | Medquest Imaging L.l.c | Physiological Laboratory | 3400 Fleckenstein Rd, Flint, MI 48507-3042 | 2014-09-12 |
| 1801209549 | Comprehensive Pain Specialists, Pllc | Pain Medicine | 3400 Fleckenstein Rd, Suite 1, Flint, MI 48507-3042 | 2014-06-10 |
| 1255696092 | Douglas Joseph Boven II | Physical Medicine & Rehabilitation | 3400 Fleckenstein Rd, Flint, MI 48507-3042 | 2012-07-09 |
| 1659664092 | Bps-sar Pllc | Physical Medicine & Rehabilitation | 3400 Fleckenstein Rd, Suite 4, Flint, MI 48507-3042 | 2011-05-18 |
| 1265687321 | Millenium North PC | Internal Medicine | 3400 Fleckenstein Rd, Suite 3, Flint, MI 48507-3043 | 2008-11-17 |
| 1760638241 | Mid Michigan Diagnostic Corp | Radiology | 3400 Fleckenstein Rd, Suite D, Flint, MI 48507-3043 | 2008-08-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245847870 | Alexis Nichole Leach | Physician Assistant | 5494 South Dort Hwy, Flint, MI 48507 | 2020-09-28 |
| 1508330317 | Jeffrey Mark Funck | Registered Nurse | G-4443 Miller Road, Suite 100, Flint, MI 48507 | 2019-01-15 |
| 1861981292 | Lavonne L Alexander | Nurse Practitioner | 4500 S Saginaw St Ste 1875, Flint, MI 48507 | 2018-05-01 |
| 1760984348 | Melissa Dawn Hoffman | Psychologist | 5402 Gateway Centre Drive, Suite B, Flint, MI 48507 | 2018-02-28 |
| 1902327323 | Katee Mast | Case Manager/Care Coordinator | 110 Eldon Baker Drive, Flint, MI 48507 | 2017-07-06 |
| 1699228460 | Joshua Sinclair | Social Worker | 2442 E Maple Ave Ste 207, Flint, MI 48507 | 2016-07-28 |
| 1477903730 | Gracie Hunter | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1110 Eldon Baker, Flint, MI 48507 | 2016-06-17 |
| 1528412822 | Drita Gojcaj | Massage Therapist | 3426 Miller Road, Flint, MI 48507 | 2016-04-22 |
| 1629422100 | Ellen Makarewicz-ely | Massage Therapist | 3426 Miller Rd, Flint, MI 48507 | 2016-04-20 |
| 1700262722 | Katelyn Bailey | Nurse Practitioner | 1420 W Twelfth St, Flint, MI 48507 | 2015-07-31 |
| Find all providers in zip 48507 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528414240 | Jonathan Wood | Specialist | 512 W 2nd Ave, Flint, MI 48503-2516 | 2016-05-11 |
| 1124393079 | Stephanie N Keller | Specialist | 338 Browning Ave, Flint, MI 48507-2621 | 2012-03-11 |
| 1154566727 | Daniel T Anbe | Specialist | 6326 W Cimarron Trl, Flint, MI 48532-2019 | 2008-12-10 |
| 1841444007 | Michigan Interventional Radiology Associates, PC | Specialist | 2370 S Linden Rd Ste 300, Flint, MI 48532-5429 | 2008-11-13 |
| 1689828188 | Mark Douglas Barton | Specialist | 1308 Ida St, Flint, MI 48503-3526 | 2008-11-11 |
| 1316104177 | Neelam Dutt Md PC | Specialist | G3535 Beecher Rd Ste H, Flint, MI 48532-2700 | 2008-05-20 |
| 1518145093 | Ahmed Zaki | Specialist | 1230 S Linden Rd, Flint, MI 48532-3459 | 2008-02-06 |
| 1558559575 | Flint Cardiovascular Assoc. Plc | Specialist | 1116 S Linden Rd Ste 14, Flint, MI 48532-3418 | 2007-10-04 |
| 1053513184 | Marta Bonkowski, M.d., P.C. | Specialist | 5105 W Bristol Rd, Flint, MI 48507-2921 | 2007-06-01 |
| 1639387244 | Michigan Gastroenterology Clinic, PC | Specialist | 5059 Villa Linde Pkwy Ste 28, Flint, MI 48532-3438 | 2007-05-18 |
| Find all providers in FLINT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.