JANET MARIE MARINELLI (NPI# 1093938128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093938128 |
| Entity Type | Individual |
| Full Name | JANET MARIE MARINELLI |
| Other Name | JANET MARIE IOGA |
| Credential | PA-C |
| Practice Address |
25 Riviera Blvd Lake Havasu City AZ 86403-5694 |
| Practice Telephone | 9285055555 |
| Practice Fax Number | 9285055557 |
| Mailing Telephone | 9285055555 |
| Mailing Fax Number | 9285055557 |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2015-02-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 3604 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
3604 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
3604 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | LICENSE | 3604 | 01 |
| AZ | 378599 | 05 |
| Street Address |
25 RIVIERA BLVD |
| City | LAKE HAVASU CITY |
| State | AZ |
| Zip Code | 86403-5694 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205813565 | Ronald Bernard Killian | Podiatrist | 25 Riviera Blvd, Lake Havasu City, AZ 86403-5694 | 2005-12-28 |
| 1912524380 | Lakeside Orthopedic Institute, LLC | Clinic/Center | 25 Riviera Blvd, Lake Havasu City, AZ 86403-5694 | 2020-07-01 |
| 1083265573 | Anita Gail Martin | Physical Therapist | 25 Riviera Blvd, Lake Havasu City, AZ 86403-5694 | 2019-09-25 |
| 1154780633 | Lakeside Physical Therapy, Rehab & Sports Medicine | Specialist/Technologist | 25 Riviera Blvd, Lake Havasu City, AZ 86403-5694 | 2016-02-12 |
| 1679764229 | Lakeside Orthopedic Institute LLC | Orthopaedic Surgery | 25 Riviera Blvd, Lake Havasu City, AZ 86403-5694 | 2007-08-08 |
| 1043245293 | William F Binder | Orthopaedic Surgery | 25 Riviera Blvd, Lake Havasu City, AZ 86403-5694 | 2006-07-12 |
| 1558331181 | Derek M Burnett | Physical Medicine & Rehabilitation | 25 Riviera Blvd, Lake Havasu City, AZ 86403-5694 | 2006-01-25 |
| 1841270873 | Daniel Edward Heiner | Orthopaedic Surgery | 25 Riviera Blvd, Lake Havasu City, AZ 86403-5694 | 2006-01-17 |
| 1649265596 | Eung Jun Cha | Orthopaedic Surgery | 25 Riviera Blvd, Lake Havasu City, AZ 86403-5694 | 2005-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104479039 | Liska's Apothecary Shop, Inc. | Assisted Living Facility | 1840 Mesquite Ave., Ste. E, Lake Havasu City, AZ 86403 | 2019-07-19 |
| 1275033227 | Ayad Costy | Pharmacist | 75 North Lake Havasu City, Lake Havasu City, AZ 86403 | 2018-02-16 |
| 1942727250 | Ideal Health Care, L.L.C. | Prosthetic/Orthotic Supplier | 1675 Mesquite Ave Ste A, Lake Havasu City, AZ 86403 | 2017-08-28 |
| 1063965036 | Cerner Health Connections, Inc | Clinic/Center | 89 Civic Center Blvd, Lake Havasu City, AZ 86403 | 2016-07-26 |
| 1447643358 | Lundin Dental PC | Durable Medical Equipment & Medical Supplies | 1741 Mesquite Avenue Ste B 100, Lake Havasu City, AZ 86403 | 2015-03-17 |
| 1912301425 | Arizona Havasu Bdm Pak LLC | Dentist | 1799 North Kiowa Blvd, Unit 109, Lake Havasu, AZ 86403 | 2014-10-13 |
| 1386047850 | Emily E Vona | Nurse Practitioner | 84 Acoma Blvd N Ste 104, Lake Havasu City, AZ 86403 | 2014-09-29 |
| 1750700589 | Thomas Wennergren | Pharmacist | 25 S Lake Havasu Ave, Lake Havasu City, AZ 86403 | 2014-04-09 |
| 1285997460 | Jamie L Lemire | Pharmacist | 1980 Mcculloch Blvd, Lake Havasu City, AZ 86403 | 2012-06-21 |
| 1053694448 | Goodwill of Northern Arizona | Exclusive Provider Organization | 1990 Mcculloch Blvd North, Lake Havasu City, AZ 86403 | 2011-09-22 |
| Find all providers in zip 86403 | ||||
| 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 |
|---|---|---|---|---|
| 1194103416 | George Macey | Physician Assistant | 3868 Mission Dr N, Lake Havasu City, AZ 86406-4435 | 2015-05-07 |
| 1124414693 | Matthew Preston Rainbolt | Physician Assistant | 3619 Desert Rose Ln, Lake Havasu City, AZ 86404-1748 | 2015-04-12 |
| 1285920991 | Nicole Anne Ballentine | Physician Assistant | 1840 Mesquite Ave Ste G102, Lake Havasu City, AZ 86403 | 2011-06-21 |
| 1598873044 | Sharon E. Polacca | Physician Assistant | 2035 Mesquite Suite E, Lake Havasu City, AZ 86403 | 2006-08-25 |
| 1972577088 | James T Corbett | Physician Assistant | 1810 Mesquite Ave Ste B, Lake Havasu City, AZ 86403-5886 | 2006-02-15 |
| 1659995652 | Alana Stern | Physician Assistant | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2020-06-04 |
| 1891276630 | Brian Andrew | Physician Assistant | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2018-08-28 |
| 1144776055 | Paul Queior | Physician Assistant | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2016-08-30 |
| 1366862526 | Kyle Fjerstad | Physician Assistant | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2014-04-25 |
| 1730296088 | Julie M. Mcguire | Physician Assistant | 2035 Mesquite Ave, Suite E, Lake Havasu City, AZ 86403-5894 | 2006-08-24 |
| Find all providers in LAKE HAVASU CITY | ||||
| City | LAKE HAVASU CITY |
| Zip Code | 86403 |
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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.