SARAH J SELIS (NPI# 1083044259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083044259 |
| Entity Type | Individual |
| Full Name | SARAH J SELIS |
| Other Name | SARA J ETHRIDGE |
| Credential | PA-C |
| Practice Address |
1111 Leffingwell Ave Ne Grand Rapids MI 49525-6406 |
| Practice Telephone | 6164597101 |
| Practice Fax Number | 6164646170 |
| Mailing Telephone | 6164597101 |
| Mailing Fax Number | 6164646170 |
| Enumeration Date | 2013-11-25 |
| Last Update Date | 2020-08-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 5601006811 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4100 Lake Dr Se Ste 300, Grand Rapids, MI 495468292 | 6162678860 | |
| 555 Midtowne St Ne Ste 105, Grand Rapids, MI 495035731 | 6164597101 | 6164646170 |
| Street Address |
1111 LEFFINGWELL AVE NE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49525-6406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437151834 | William G Brinkmeier | Physician Assistant | 1111 Leffingwell Ave Ne, Ste 100, Grand Rapids, MI 49525-6406 | 2005-08-15 |
| 1316571334 | Beth A Ronda | Occupational Therapist | 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 | 2020-02-28 |
| 1811535172 | Kaylyn Fales | Specialist/Technologist | 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 | 2019-12-18 |
| 1275170540 | Marissa Marguerite Hansen | Physical Therapist | 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 | 2019-12-05 |
| 1285120568 | Danielle M Beaudoin | Physical Therapist | 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 | 2018-07-10 |
| 1235630203 | Michael D Newlin | Physical Therapist | 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 | 2018-02-26 |
| 1649787128 | Corey John Koll | Physician Assistant | 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 | 2018-01-05 |
| 1144735093 | Bradley M Griffin | Occupational Therapist | 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 | 2017-12-13 |
| 1811412315 | Logan M Neil | Physical Therapist | 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 | 2017-08-07 |
| 1053848929 | Hilary May Fredricks | Physical Therapist | 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 | 2017-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053928507 | Therapy With Nicole Pllc | Community/Behavioral Health | 4867 E. Beltline Ave. Ne, Building #1 Lower Level, Grand Rapids, MI 49525 | 2020-09-29 |
| 1184242760 | Christian Healthcare Specialists, Inc. | Obstetrics & Gynecology | 3322 Beltline Court Ne, Suite 1, Grand Rapids, MI 49525 | 2020-07-09 |
| 1174154645 | Amy Vanderslik | Case Manager/Care Coordinator | 3310 Eaglecrest Park Dr. Ne, Suite 100, Grand Rapids, MI 49525 | 2020-02-03 |
| 1477195246 | Epic Discoveries LLC | Counselor | 4867 E. Beltline Ave Ne, Grand Rapids, MI 49525 | 2019-10-14 |
| 1598228959 | Kim Scherencel Lmsw Counseling | Social Worker | 3280 Beltline Ne, Grand Rapids, MI 49525 | 2019-04-11 |
| 1821558958 | Mindful Trajectories | Social Worker | 3280 Beltlne Ct Ne, Grand Rapids, MI 49525 | 2019-03-24 |
| 1104380518 | Julianne Lettinga, Ma Lpc Counseling | Counselor | 3280 East Beltline Ct Ne, Grand Rapids, MI 49525 | 2019-01-30 |
| 1396227229 | Christopher Scot Doucette | Social Worker | 2064 Airway St Ne, Grand Rapids, MI 49525 | 2018-09-06 |
| 1568976017 | Amy K. Deyoung, Dds, Ms, PC Pediatric Dentistry | Dentist | 3297 Eagle Run Dr. Ne, Grand Rapids, MI 49525 | 2017-11-20 |
| 1407389604 | Kelly Jo Crabb | Social Worker | 4829 E Beltline Ave Ne Ste 100, Grand Rapids, MI 49525 | 2017-04-05 |
| Find all providers in zip 49525 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609473198 | Rachel M. Graziano | Physician Assistant | 18 Lowell Ave Ne, Grand Rapids, MI 49503-3760 | 2020-10-07 |
| 1811537269 | Joseph Salvatore Giovannucci | Physician Assistant | 145 Michigan St Ne Ste 2230, Grand Rapids, MI 49503-2562 | 2020-01-14 |
| 1326685686 | Mitchell Lebel | Physician Assistant | 932 Fulton St E Unit 1, Grand Rapids, MI 49503-3565 | 2019-12-05 |
| 1326680331 | Emily Wallace | Physician Assistant | 1661 Philadelphia Ave Se, Grand Rapids, MI 49507-2251 | 2019-10-10 |
| 1124688197 | Leeann Marie Kuehn | Physician Assistant | 218 Warren Ave Se, Grand Rapids, MI 49506-1582 | 2019-06-20 |
| 1770057549 | Shelby Elizabeth Hunt | Physician Assistant | 100 Michigan St Ne # Mc9017, Grand Rapids, MI 49503-2560 | 2019-01-15 |
| 1063906865 | Kimberly Eccher | Physician Assistant | 300 68th St. Se, Grand Rapids, MI 49548 | 2018-06-15 |
| 1174029094 | Katrina Ann Brummel | Physician Assistant | 555 Midtowne St Ne Ste 110, Grand Rapids, MI 49503-5731 | 2018-03-30 |
| 1902312994 | Aaron Michaud | Physician Assistant | 301 Barclay Ave Ne, Grand Rapids, MI 49503 | 2017-12-28 |
| 1538687215 | Sonia Nicola | Physician Assistant | 4100 Embassy Dr Se Ste 400, Grand Rapids, MI 49546-2416 | 2017-09-01 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49525 |
Please comment or provide details below to improve the information on SARAH J SELIS.
| 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.