SHERISE L.E. DEARDORFF (NPI# 1164738662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164738662 |
| Entity Type | Individual |
| Full Name | SHERISE L.E. DEARDORFF |
| Other Name | SHERISE L.E DENNY |
| Credential | PA-C |
| Practice Address |
200 High Park Ave Goshen IN 46526-4810 |
| Practice Telephone | 5743642888 |
| Enumeration Date | 2010-08-23 |
| Last Update Date | 2015-04-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
10001777A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
085003822 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
200 HIGH PARK AVE |
| City | GOSHEN |
| State | IN |
| Zip Code | 46526-4810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255339537 | Helen Winer-muram | Radiology | 200 High Park Ave, Goshen, IN 46526-4810 | 2005-07-12 |
| 1295336642 | Marlise Ann Webber | Nurse Practitioner | 200 High Park Ave, Goshen, IN 46526-4810 | 2020-11-03 |
| 1952940538 | Adrianne Osano | Dietitian, Registered | 200 High Park Ave, Goshen, IN 46526-4810 | 2019-12-31 |
| 1427695642 | Neltje Ribbens | Dietitian, Registered | 200 High Park Ave, Goshen, IN 46526-4810 | 2019-12-06 |
| 1144885013 | Devon Lee Perkins | Physician Assistant | 200 High Park Ave, Goshen, IN 46526-4810 | 2019-05-07 |
| 1699232553 | Maya Bar-zvi | Dietitian, Registered | 200 High Park Ave, Goshen, IN 46526-4810 | 2019-02-27 |
| 1689164477 | Grace Catherine Darnell | Registered Nurse | 200 High Park Ave, Goshen, IN 46526-4810 | 2018-05-16 |
| 1750881991 | Bethany Swope | Marriage & Family Therapist | 200 High Park Ave, Goshen, IN 46526-4810 | 2018-02-14 |
| 1881102168 | Leon Carroll Coody Jr. | Nurse Practitioner | 200 High Park Ave, Goshen, IN 46526-4810 | 2018-01-20 |
| 1386169530 | Ashley Outman | Dietitian, Registered | 200 High Park Ave, Goshen, IN 46526-4810 | 2017-08-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134631344 | Heidi Kauffmann | Social Worker | 2606 Peddler's Village Rd. Suite 210, Goshen, IN 46526 | 2017-10-27 |
| 1952812034 | Blue Diamond Villas | Skilled Nursing Facility | 1510 Sandpiper Lane, Goshen, IN 46526 | 2017-10-17 |
| 1578086534 | Anthony Escotto | Physical Therapist | 223 North Chicago Avenue, Goshen, IN 46526 | 2017-07-21 |
| 1831544774 | April Noelle Hart | Registered Nurse | 2606 Peddlers Village Rd., Suite 215, Goshen, IN 46526 | 2016-04-28 |
| 1639530108 | Amanda Miller | Physical Therapy Assistant | 114 Watertower Court, Goshen, IN 46526 | 2016-03-11 |
| 1720486095 | Gloria White | Pharmacist | 4430 Elkhart Road, C/o Walgreens, Goshen, IN 46526 | 2014-12-18 |
| 1184982472 | Dianna Christine Hoover | Occupational Therapist | 1627 Autumn Blaze Lane, Goshen, IN 46526 | 2012-04-24 |
| 1629361357 | Amy Rebecca Pointon | Nurse Practitioner | 1615 Winsted Dr Ste 1, Goshen, IN 46526 | 2011-05-27 |
| 1659670685 | Michiana Eye Center LLC | Optometrist | 1747 Stafford Ct, Goshen, IN 46526 | 2011-03-16 |
| 1467759001 | Natasha Candace Pontius | Occupational Therapy Assistant | 2400 College Aveune, Goshen, IN 46526 | 2011-02-17 |
| Find all providers in zip 46526 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073897914 | Kaitlyn J Barbalich | Physician Assistant | 30 Matthews St #105, Goshen, NY 10924-1985 | 2011-10-10 |
| 1104958909 | Aviva Frommer | Physician Assistant | 70 Hatfield Ln, Suite 204, Goshen, NY 10924-6734 | 2007-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063019289 | Timothy Jeffirs | Physician Assistant | 10662 12th Rd, Argos, IN 46501-9551 | 2020-10-01 |
| 1093321788 | April Marie Przyborski | Physician Assistant | 1701 S Creasy Ln Ste 2j20, Lafayette, IN 47905-4972 | 2020-09-18 |
| 1124634936 | Brilyn Michelle Banister | Physician Assistant | 8443 Cabin Creek Dr Apt G, Indianapolis, IN 46237-6330 | 2020-09-17 |
| 1386290625 | Douglas R Day | Physician Assistant | 1701 N Senate Blvd # Ag373a, Indianapolis, IN 46202-1239 | 2019-08-13 |
| 1841851409 | Rachel Jagrowski | Physician Assistant | 1801 N Senate Blvd Ste 700, Indianapolis, IN 46202-1177 | 2019-06-25 |
| 1366003154 | Jimmy Garala | Physician Assistant | 101 E 87th Ave Fl A3, Merrillville, IN 46410-7335 | 2019-06-24 |
| 1407311814 | William Peter Thompson | Physician Assistant | 1801 N Capitol Ave # Npe120, Indianapolis, IN 46202-1217 | 2019-02-11 |
| 1669954475 | Erika Vanelle Marin | Physician Assistant | 2680 Escalade Way, Warsaw, IN 46582 | 2018-08-29 |
| 1225518228 | Jie Xu | Physician Assistant | 2072 E Commercial Ave, Lowell, IN 46356-2116 | 2018-08-19 |
| 1912492679 | Katherine Barrett Tenbarge | Physician Assistant | 1800 N Capitol Ave # E140, Indianapolis, IN 46202-1218 | 2018-06-26 |
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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.