KRISTIN MARIE GROESSL (NPI# 1093797250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1093797250 |
Entity Type | Individual |
Full Name | KRISTIN MARIE GROESSL |
Credential | PA-C |
Practice Address |
260 Hospital Dr Ste 107 Ukiah CA 95482 |
Mailing Address |
260 Hospital Dr Ste 107 Ukiah CA 95482-4568 |
Practice Telephone | 7074637627 |
Enumeration Date | 2005-11-15 |
Last Update Date | 2018-11-13 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363A00000X | Physician Assistant | 1164-023 | WI | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
56266 | CA | Physician Assistants & Advanced Practice Nursing Providers |
N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
1164-023 | WI | Physician Assistants & Advanced Practice Nursing Providers |
Address | Telephone Number | Fax Number |
---|---|---|
12203 Corporate Pkwy, Mequon, WI 530923388 | 2623878200 | 2623878271 |
Street Address |
260 HOSPITAL DR STE 107 |
City | UKIAH |
State | CA |
Zip Code | 95482 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447647771 | Brian Scott Gould | Family Medicine | 260 Hospital Dr Ste 107, Ukiah, CA 95482-4568 | 2015-04-24 |
1386957785 | Ephraim Dickinson | Orthopaedic Surgery | 260 Hospital Dr Ste 107, Ukiah, CA 95482 | 2010-07-15 |
1922334671 | Mark E. Trump | Orthopaedic Surgery | 260 Hospital Dr Ste 107, Ukiah, CA 95482 | 2009-10-29 |
1932152667 | Adrian B Obuch | Orthopaedic Surgery | 260 Hospital Dr Ste 107, Ukiah, CA 95482 | 2006-05-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932726726 | Gloria Gonzalez Campise | Midwife | 205 W. Clay Street, Ukiah, CA 95482 | 2020-06-29 |
1083255095 | Mendocino Care Network | Internal Medicine | 1080 N State St, Ukiah, CA 95482 | 2019-10-01 |
1801383153 | Costco Wholesale Corporation | Pharmacy | 1275 Airport Park Blvd., Ukiah, CA 95482 | 2018-04-21 |
1922528256 | Ian David Winter | Case Manager/Care Coordinator | 1120 S. Dora St, Ukiah, CA 95482 | 2017-06-27 |
1568917938 | Rebecca Ann Dragomani | Nurse Practitioner | 260 Hospital Dr Ste 101, Ukiah, CA 95482 | 2016-08-16 |
1811362536 | Manzanita Services, Inc. | Community/Behavioral Health | 410 W. Jones St., Ukiah, CA 95482 | 2015-12-07 |
1689061061 | Pamela Mathias | Counselor | 367 East Gobbi Street, Suite E, Ukiah, CA 95482 | 2015-04-23 |
1275927030 | Jack David Segel | Counselor | 564 Dora St., Ste.d, Ukiah, CA 95482 | 2015-03-19 |
1689070211 | Mendocino County Youth Project | Clinic/Center | 347 Plum St, #b, Ukiah, CA 95482 | 2014-11-10 |
1346649951 | Ae Ran Ku | Dentist | 1096 South Dora Street, Ukiah, CA 95482 | 2014-08-19 |
Find all providers in zip 95482 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649894403 | Kathlyn Larco | Physician Assistant | 1233 W Randall Way, West Covina, CA 91790-4747 | 2020-06-07 |
1487126421 | Eliza Hughes | Physician Assistant | 860 Oak Park Blvd Ste 101, Arroyo Grande, CA 93420-1800 | 2018-12-31 |
1508333873 | Andrew Cantos Malit | Physician Assistant | 409 Bristol Way, Corona, CA 92879-6156 | 2018-10-25 |
1578049458 | Ida Jelveh | Physician Assistant | 28096 Edelweiss Ct, Laguna Niguel, CA 92677-7006 | 2018-07-13 |
1356833578 | Michael James Gonzalez | Physician Assistant | 1500 E Chevy Chase Dr # 401a401b, Glendale, CA 91206-4152 | 2018-06-04 |
1023500592 | Pamela Lambert Pa-c, Inc. | Physician Assistant | 16105 Mariposa Ave, Riverside, CA 92504-8730 | 2018-05-31 |
1225532385 | Folsom Physicain Assistant First Assist, Inc | Physician Assistant | Nina Vasiliev Pa-c, 15407 Muller Rd, Plymouth, CA 95669-9770 | 2018-03-22 |
1275040008 | Gm Surgical Assistant Inc | Physician Assistant | 15615 Turnberry St, Moreno Valley, CA 92555-4901 | 2018-01-02 |
1902311186 | Or Solutions Inc | Physician Assistant | 1501 Secret Ravine Pkwy Unit 527, Roseville, CA 95661-6005 | 2017-12-09 |
1184143828 | Alaa Abdalla Daghlas | Physician Assistant | 1100 S Eliseo Dr Ste A, Greenbrae, CA 94904-2017 | 2017-09-13 |
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.