DR. JACLYN SUMMER LISTON-CRANDALL (NPI# 1114145133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114145133 |
| Entity Type | Individual |
| Full Name | DR. JACLYN SUMMER LISTON-CRANDALL |
| Credential | M.D. |
| Practice Address |
2218 Us Highway 27 N Tekonsha MI 49092-9261 |
| Practice Telephone | 5177674038 |
| Practice Fax Number | 5177673427 |
| Mailing Telephone | 5177674038 |
| Mailing Fax Number | 5177673427 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2014-12-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 4301089625 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
2218 US HIGHWAY 27 N |
| City | TEKONSHA |
| State | MI |
| Zip Code | 49092-9261 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225099898 | David L. Lambrix | Family Medicine | 2218 Us Highway 27 N, Tekonsha, MI 49092-9261 | 2006-03-31 |
| 1174971170 | Mehmiya Raghid | Family Medicine | 2218 Us Highway 27 N, Tekonsha, MI 49092-9261 | 2016-05-31 |
| 1114390051 | Lisa Wireman | Nurse Practitioner | 2218 Us Highway 27 N, Tekonsha, MI 49092-9261 | 2015-10-31 |
| 1023456159 | Tiffany M Burns | Family Medicine | 2218 Us Highway 27 N, Tekonsha, MI 49092-9261 | 2013-06-11 |
| 1558619908 | Christine Claire Nault | Nurse Practitioner | 2218 Us Highway 27 N, Tekonsha, MI 49092-9261 | 2012-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811941206 | Jackalyn M Govier | Family Medicine | 2218 Old Us 27 N, Tekonsha, MI 49092 | 2006-05-20 |
| 1326164880 | Gretchen Marie Stefanski | Pharmacist | 129 North Main Street Box 217, Tekonsha, MI 49092-0217 | 2007-03-22 |
| 1457453870 | Evans Drugs of Tekonsha LLC | Pharmacy | 129 N Main St, Tekonsha, MI 49092-5114 | 2006-09-05 |
| 1952859902 | Gabrielle Kay Seiler | Rehabilitation Practitioner | 537 Herricksville Rd, Tekonsha, MI 49092-9667 | 2016-09-20 |
| 1689128209 | Mary Katherine Mills | Dietitian, Registered | 394 Lincoln Dr, Tekonsha, MI 49092-9685 | 2016-08-11 |
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811941206 | Jackalyn M Govier | Family Medicine | 2218 Old Us 27 N, Tekonsha, MI 49092 | 2006-05-20 |
| 1225099898 | David L. Lambrix | Family Medicine | 2218 Us Highway 27 N, Tekonsha, MI 49092-9261 | 2006-03-31 |
| 1174971170 | Mehmiya Raghid | Family Medicine | 2218 Us Highway 27 N, Tekonsha, MI 49092-9261 | 2016-05-31 |
| 1023456159 | Tiffany M Burns | Family Medicine | 2218 Us Highway 27 N, Tekonsha, MI 49092-9261 | 2013-06-11 |
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|---|---|---|---|---|
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| 1447867619 | Bashar Yalldo Md Plc | Family Medicine | 14700 Farmington Rd Ste 105, Livonia, MI 48154-5434 | 2020-09-30 |
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| 1710592050 | Chippewa County War Memorial Hospital Inc | Family Medicine | 391 E M 134, Cedarville, MI 49719-9451 | 2020-09-14 |
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| 1457961054 | Danna Zevy | Family Medicine | 107 S Washington Ave Apt 401, Saginaw, MI 48607-1258 | 2020-08-07 |
| 1194342808 | Zachary Hillman Do Pllc | Family Medicine | 1794 N Lapeer Rd Ste A, Lapeer, MI 48446-7664 | 2020-06-29 |
| 1336765445 | Spectrum Health United | Family Medicine | 7188 Avenue B, Vestaburg, MI 48891-9502 | 2020-06-24 |
| 1477179711 | Spectrum Health United | Family Medicine | 1324 N County Line Rd, Blanchard, MI 49310-9303 | 2020-06-23 |
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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.