MR. JERRY ELLIS RAPERT (NPI# 1134271034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134271034 |
| Entity Type | Individual |
| Full Name | MR. JERRY ELLIS RAPERT |
| Credential | PA-C |
| Practice Address |
900 S Fairmont Ave Suite A Lodi CA 95240-5143 |
| Practice Telephone | 2093332500 |
| Practice Fax Number | 2903333779 |
| Mailing Telephone | 2093332500 |
| Mailing Fax Number | 2903333779 |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2013-12-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA11385 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STATE LIC | PA11385 | 01 |
| Street Address |
900 S FAIRMONT AVE SUITE A |
| City | LODI |
| State | CA |
| Zip Code | 95240-5143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447239744 | Mobin P Ghavami | Internal Medicine | 900 S Fairmont Ave, Ste. A, Lodi, CA 95240-5119 | 2006-01-13 |
| 1871697391 | Mitchell R Swanson | Chiropractor | 900 S Fairmont Ave, Suite B, Lodi, CA 95240-5143 | 2006-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962034991 | Dr. Jeffrey A Saladin, Dental Corporation | Dentist | 1139 E. Kettleman Lane, Suite 101, Lodi, CA 95240 | 2020-02-07 |
| 1548747082 | Gill and Patel Dental Corporation | Dentist | 2610 Reynolds Ranch Pkwy, Ste 100, Lodi, CA 95240 | 2018-07-27 |
| 1629511308 | Jose Daniel Garcia | Licensed Vocational Nurse | 12755 Ca-88, Lodi, CA 95240 | 2016-11-29 |
| 1104372754 | Jocelyn Janel Shilue | Specialist/Technologist | 705 Brandywine Drive, Lodi, CA 95240 | 2016-09-01 |
| 1750735965 | Natharchia R Peoples | Counselor | 9150 Ca-12, Lodi, CA 95240 | 2016-04-14 |
| 1891189403 | Valley Community Couseling Services | Case Management | 1300 W. Lodi Ste G-2, Stockton, CA 95240 | 2015-03-20 |
| 1114317195 | Carol Kooyman | Speech-Language Pathologist | 831 So. Lee Ave., Lodi, CA 95240 | 2015-01-29 |
| 1730514464 | Richard Barry Sirard | Pharmacist | 520 S Cherokee Lane, Lodi, CA 95240 | 2013-09-12 |
| 1740622570 | Joshlynn Uribe | Marriage & Family Therapist | 13520 E Live Oak Rd, Lodi, CA 95240 | 2013-07-22 |
| 1902172406 | Sital Singh | Internal Medicine | 999 S Fairmont Ave Ste 125, Lodi, CA 95240 | 2012-03-29 |
| Find all providers in zip 95240 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760089437 | Karine Harutyunyan | Physician Assistant | 500 E Colorado St Ste 101, Glendale, CA 91205-1607 | 2020-10-06 |
| 1437756228 | Kale Burket | Physician Assistant | Bldg 523, S 8th St, El Centro, CA 92243 | 2020-10-05 |
| 1548867666 | Heba Marzouk Al-shoubaki | Physician Assistant | 633 S Pepper St, Anaheim, CA 92802-1459 | 2020-10-01 |
| 1275140550 | Lisa Lynn Passalacqua | Physician Assistant | 431 7th St, Norco, CA 92860-1671 | 2020-09-30 |
| 1144833989 | Trisha Taylor | Physician Assistant | 10399 Tivoli Way, Yucaipa, CA 92399-6017 | 2020-08-30 |
| 1457963944 | Harlan William Monahan | Physician Assistant | 5210 Del Rio Rd, Sacramento, CA 95822-2519 | 2020-08-18 |
| 1275144313 | Sofia Carmen Bustillo | Physician Assistant | 1709 Coral Pl, Seal Beach, CA 90740-5712 | 2020-08-12 |
| 1124638663 | Gayaneh Gharakhani | Physician Assistant | 1323 E Broadway Apt 110, Glendale, CA 91205-4018 | 2020-08-07 |
| 1144830183 | Loc Bao Tran | Physician Assistant | 8937 Emerson Pl, Rosemead, CA 91770-2813 | 2020-08-04 |
| 1558997957 | Sarah Lubinsky | Physician Assistant | 1511 Montana Ave, Santa Monica, CA 90403-1891 | 2020-03-17 |
| 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.