MY PRACTITONER FAMILY PRACTICE (NPI# 1053657098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053657098 |
| Entity Type | Organization |
| Organization Name | MY PRACTITONER FAMILY PRACTICE |
| Practice Address |
2996 State Route 132 Amelia OH 45102-2404 |
| Practice Telephone | 5137480874 |
| Practice Fax Number | 5133227989 |
| Mailing Telephone | 5137480874 |
| Mailing Fax Number | 5133227989 |
| Enumeration Date | 2012-12-19 |
| Last Update Date | 2013-07-19 |
| Authorized Official Name | KATHY SUE BROCK (OWNER) |
| Authorized Official Telephone | 5137480874 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SF0001X |
Clinical Nurse Specialist Specialization: Family Health |
COA.13223-NP | OH | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2996 STATE ROUTE 132 |
| City | AMELIA |
| State | OH |
| Zip Code | 45102-2404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437679743 | Jacob Pangallo | Specialist/Technologist | 117 Chapel Rd, Amelia, OH 45102 | 2017-06-27 |
| 1336676725 | Tressa Louise Vauter | Technician | 1751 E Ohio Pike 124b., Amelia, OH 45102 | 2017-05-16 |
| 1740639988 | Buckeye Dental Care LLC. | Point of Service | 1268 Ohio Pike, Amelia, OH 45102 | 2016-06-08 |
| 1992085856 | Emily J Woodward | Nurse's Aide | 1507 Thomaston Dr, Unit F, Amelia, OH 45102 | 2011-08-24 |
| 1033320999 | American Home Health Care | Durable Medical Equipment & Medical Supplies | 1815 State Road 125, Amelia, OH 45102 | 2007-05-24 |
| 1215038849 | Patrick D Weadick | Chiropractor | 1739 E Ohio Pike, Ohio Pike Chiropractic Inc, Amelia, OH 45102 | 2006-09-26 |
| 1912434267 | Elizabeth Flynn Adams | Nurse Practitioner | 262 W Main St, Amelia, OH 45102 | 2017-05-17 |
| 1093065450 | Leslie Mae Whitacre | Pharmacist | 57 W Main St, Amelia, OH 45102 | 2012-09-13 |
| 1780983015 | Kelli Nichole Votel | Counselor | 43 East Main Street, Amelia, OH 45102 | 2011-03-25 |
| 1033226212 | Richard E Godfroy | Dentist | 105 W Main St, Amelia, OH 45102 | 2006-08-24 |
| Find all providers in zip 45102 | ||||
| Taxonomy Code | 364SF0001X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Family Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114587136 | Eric Wilhelm | Clinical Nurse Specialist | 8760 Ashton Pl, North Ridgeville, OH 44039-8701 | 2019-06-20 |
| 1073902185 | Diane Koehl | Clinical Nurse Specialist | 8859 Brookside Ave Ste 101, West Chester, OH 45069-7113 | 2015-01-13 |
| 1871999292 | Brandi L Blanton | Clinical Nurse Specialist | 1341 S Trimble Rd, Mansfield, OH 44907-2605 | 2014-11-12 |
| 1598107526 | Family Urgent Care, LLC. | Clinical Nurse Specialist | 879 N Bridge St, Chillicothe, OH 45601-1704 | 2013-07-18 |
| 1760825285 | Jeanne Ingles Family Practice | Clinical Nurse Specialist | 21 Central Ave Ste D, Gallipolis, OH 45631-1824 | 2013-04-15 |
| 1205300886 | Jon Philip Hautzenroeder | Clinical Nurse Specialist | 2139 Auburn Ave, Cincinnati, OH 45219-2906 | 2019-01-16 |
| 1275018095 | Claudia P. Rodriguez | Clinical Nurse Specialist | 2213 Cherry St, Toledo, OH 43608-2603 | 2018-09-27 |
| 1720591936 | Corinthia Niedermeier | Clinical Nurse Specialist | 5100 W Broad St, Columbus, OH 43228-1607 | 2017-11-09 |
| 1700308608 | Suvarnamala Pushkaran | Clinical Nurse Specialist | 1036 S Verity Pkwy, Middletown, OH 45044-5513 | 2017-07-12 |
| 1093257701 | Bethany Farrell | Clinical Nurse Specialist | 5700 Cooper Foster Park Rd W, Lorain, OH 44053-4152 | 2016-11-11 |
| Find all providers with the same taxonomy | ||||
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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.