TRACY LYNN DETWILER (NPI# 1154490738) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154490738 |
| Entity Type | Individual |
| Full Name | TRACY LYNN DETWILER |
| Credential | PAC |
| Practice Address |
212 E Columbus Ave Ste 1 Bellefontaine OH 43311-2033 |
| Mailing Address |
4879 Us Highway 68 S West Liberty OH 43357-9525 |
| Practice Telephone | 9375991411 |
| Practice Fax Number | 9375994128 |
| Mailing Telephone | 9375991411 |
| Mailing Fax Number | 9375994128 |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2019-05-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 50-002477 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
212 E COLUMBUS AVE STE 1 |
| City | BELLEFONTAINE |
| State | OH |
| Zip Code | 43311-2033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114527264 | Sanchita Dhond | Pharmacist | 212 E Columbus Ave Ste 1, Bellefontaine, OH 43311-2033 | 2020-10-28 |
| 1972164218 | Leanne Elizabeth Spring | Nurse Practitioner | 212 E Columbus Ave Ste 1, Bellefontaine, OH 43311-2033 | 2019-06-26 |
| 1497214001 | Community Health & Wellness Partners of Logan County | Clinic/Center | 212 E Columbus Ave Ste 1, Bellefontaine, OH 43311-2033 | 2019-03-14 |
| 1477026672 | Bethany Renee Henry | Counselor | 212 E Columbus Ave Ste 1, Bellefontaine, OH 43311-2033 | 2019-01-10 |
| 1336649599 | Community Health & Wellness Partners of Logan County | Clinic/Center | 212 E Columbus Ave Ste 1, Bellefontaine, OH 43311 | 2018-02-14 |
| 1558890657 | Nancy Byers Schmelzer | Nurse Practitioner | 212 E Columbus Ave Ste 1, Bellefontaine, OH 43311-2033 | 2017-06-12 |
| 1497295885 | Jordan Thurman | Social Worker | 212 E Columbus Ave Ste 1, Bellefontaine, OH 43311 | 2017-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760082515 | Liza Hensley | Pharmacist | 2281 S. Main Street, Bellefontaine, OH 43311 | 2020-10-30 |
| 1285273367 | Mona Kaye Garrison | Family Medicine | 1860 S Main St, Bellefontaine, OH 43311 | 2020-01-06 |
| 1316429012 | Hana Elizabeth Fischesser | Speech-Language Pathologist | 205 Palmer Street, Bellefontaine, OH 43311 | 2018-08-30 |
| 1063934719 | Sophia Do Vang | Physician Assistant | 1860 S Main Street, Bellefontaine, OH 43311 | 2017-07-14 |
| 1164978441 | Jennifer Gaver | Specialist | 921 Rush Avenue, Bellefontaine, OH 43311 | 2016-08-28 |
| 1598186561 | Candice Nanette Stevens | Registered Nurse | 208 Blair Ave, Bellefontaine, OH 43311 | 2013-12-18 |
| 1225395361 | Nicholas J Peters | Orthopaedic Surgery | 1134 N Main St Ste 2500, Bellefontaine, OH 43311 | 2012-04-13 |
| 1679868889 | Melissa Rae Lallo | Physical Therapist | 711 Rush Avenue, Bvellefontaine, OH 43311 | 2011-06-15 |
| 1912146572 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 141 Richard Avenue, Bellefontaine, OH 43311 | 2009-02-05 |
| 1710126370 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 329 East Spring Avenue, Bellefontaine, OH 43311 | 2009-02-05 |
| Find all providers in zip 43311 | ||||
| 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 |
|---|---|---|---|---|
| 1063934719 | Sophia Do Vang | Physician Assistant | 1860 S Main Street, Bellefontaine, OH 43311 | 2017-07-14 |
| 1881125706 | Chelsea Mangia Freels | Physician Assistant | 1850 S Main St, Bellefontaine, OH 43311-1512 | 2017-03-22 |
| 1023377298 | Angie Marlene Castle | Physician Assistant | 205 Palmer Ave, Bellefontaine, OH 43311 | 2012-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750221 | Kathryn Eileen Aurand | Physician Assistant | 1020 E 346th St, Eastlake, OH 44095-2629 | 2020-11-06 |
| 1508467010 | Amanda Dawn Smith | Physician Assistant | 1621 Spruce St, Zanesville, OH 43701-2534 | 2020-11-03 |
| 1356941603 | Ingrid Mompoint-butler | Physician Assistant | 1911 Oakland Park Ave, Columbus, OH 43224-3630 | 2020-10-27 |
| 1083213946 | Breanne Lyon | Physician Assistant | 870 S Troy Ave, Cincinnati, OH 45246-4620 | 2020-10-21 |
| 1669071908 | Hannah Murrin | Physician Assistant | 4329 Marival Way, Mason, OH 45040-2867 | 2020-10-19 |
| 1861091241 | Beau Webb | Physician Assistant | 6017 Cruxten Dr, Dayton, OH 45424-3702 | 2020-10-18 |
| 1467051821 | Kelsey Nicole Weiss | Physician Assistant | 9025 Peacock Way Unit 206, West Chester, OH 45069-1659 | 2020-10-18 |
| 1215535489 | Caitlin Cahill | Physician Assistant | 2470 Merrybell Ct, Grove City, OH 43123-8724 | 2020-10-11 |
| 1174121461 | Thuy Lam Pham | Physician Assistant | 505 Brodywood Dr, Toledo, OH 43615-4589 | 2020-10-09 |
| 1508463506 | John Ronald Creighton | Physician Assistant | 7460 Marion St Apt B, Chesterhill, OH 43728-9613 | 2020-10-03 |
| Find all providers with the same taxonomy | ||||
| City | BELLEFONTAINE |
| Zip Code | 43311 |
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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.