JESSE KOGELMAN


Address: 550 Munson Ave, Suite 200, Traverse City, MI 49686-3580
Phone: 2319358717

JESSE KOGELMAN (NPI# 1144503491) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1144503491
Entity Type Individual
Full Name JESSE KOGELMAN
Credential PA-C
Practice Address 550 Munson Ave
Suite 200
Traverse City
MI 49686-3580
Practice Telephone 2319358717
Practice Fax Number 2319359230
Mailing Telephone 2319358717
Mailing Fax Number 2319359230
Enumeration Date 2011-09-22
Last Update Date 2015-10-02
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
5601006005 MI Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 550 MUNSON AVE
SUITE 200
City TRAVERSE CITY
State MI
Zip Code 49686-3580

Providers in the same location

NPI Name Taxonomy Address Enumeration
1205839131 William H. George Internal Medicine 550 Munson Ave, Traverse City, MI 49686 2005-05-24
1265054936 Erynne Louise Russell Speech-Language Pathologist 550 Munson Ave, Traverse City, MI 49686-3580 2020-05-15
1821624545 Susan Carol Spencer Speech-Language Pathologist 550 Munson Ave, Traverse City, MI 49686-3580 2020-03-13
1346807617 Mary Priestly Physician Assistant 550 Munson Ave, Traverse City, MI 49686-3580 2019-05-22
1194380493 Kimberly A Chandler Health Educator 550 Munson Ave, Traverse City, MI 49686-3580 2019-05-02
1942770946 Caroline Kiley Physical Therapist 550 Munson Ave, Traverse City, MI 49686-3580 2018-12-03
1851861850 Grace Blankenhagen Physical Therapist 550 Munson Ave, Traverse City, MI 49686-3580 2018-12-03
1316429863 Elizabeth Marie Teklinski Counselor 550 Munson Ave, Traverse City, MI 49686-3580 2018-08-31
1326544230 Kaitlyn Troutman Nurse Practitioner 550 Munson Ave, Traverse City, MI 49686-3580 2018-04-02
1598267254 Teresa Lynn Hearne Physical Therapist 550 Munson Ave, Traverse City, MI 49686-3580 2018-03-08
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1245877208 Jessica Marie Glowacki Behavior Technician 935 Hemlock St, Traverse City, MI 49686 2019-12-09
1568011542 Joanne Kressley Technician 1693 Maylane Apt. 104, Traverse City, MI 49686 2019-09-11
1194283846 Pace North PACE Provider Organization 2325 Garfield Road N., Traverse City, MI 49686 2019-03-12
1245749225 Margaret Anne Goss Speech-Language Pathologist 1105 E. Eighth Street, Traverse City, MI 49686 2017-09-22
1467981811 Joan Joyce Shirilla Social Worker 2124 Twin Eagles Dr, Traverse City, MI 49686 2017-06-08
1770028763 Rehab and Mobility Systems, LLC Durable Medical Equipment & Medical Supplies 707 Parsons, Traverse City, MI 49686 2016-12-29
1629511316 Kaitlyn Grangood Social Worker 415 Munson Avenue, Ste 101, Traverse City, MI 49686 2016-11-29
1811441132 Jeffrey D Goodwin Counselor 430 Fair St., Traverse City, MI 49686 2016-08-04
1053779918 Thomas Osborne Counselor 2014 Phelps Rd., Traverse City, MI 49686 2016-02-08
1982079588 Marsha Lynne Dallas Counselor 2240 South Airport Road, Traverse City, MI 49686 2015-12-08
Find all providers in zip 49686

Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1992810360 Laura Leigh Worthington Physician Assistant 13491 S Bugai Rd, Traverse City, MI 49684-8421 2006-08-19
1598752768 Perry Ray Tiernan Physician Assistant 3074 Us 31 S, Traverse City, MI 49684-4533 2005-10-04
1114928637 Mary Kathryn Douglas Physician Assistant 5015 N Royal Dr, Traverse City, MI 49684-9292 2005-08-09
1043857196 Derek Hendrickson Physician Assistant 1200 Sixth St Ste 200, Traverse City, MI 49684-2369 2019-12-09
1649735226 Morgan Kelsey Olson Physician Assistant 1105 Sixth St, Traverse City, MI 49684-2345 2019-02-07
1851833198 Katharine Ella Venner Physician Assistant 1105 6th St, Traverse City, MI 49684-2349 2016-11-16
1427417708 Christine E Miliken Physician Assistant 3074 N Us 31 S, Traverse City, MI 49684-4533 2016-02-16
1952691768 Alisha Marie Cole Physician Assistant 4045 W Royal Dr, Traverse City, MI 49684-8965 2011-04-13
1467606350 Carrie M Sorensen Physician Assistant 1200 Sixth St Ste 200, Traverse City, MI 49684-2369 2008-11-05
1336397538 Andrij Ihor Lawrin Physician Assistant 1105 Sixth St, Traverse City, MI 49684-2345 2008-09-03
Find all providers in TRAVERSE CITY

Competitor

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City TRAVERSE CITY
Zip Code 49686

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Dataset Information

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.

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