MRS. LORA JEANETTE MANDERS (NPI# 1194133082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194133082 |
| Entity Type | Individual |
| Full Name | MRS. LORA JEANETTE MANDERS |
| Credential | MA, LLPC, CAADC, PAC |
| Practice Address |
6869 S Occidental Rd Tecumseh MI 49286-9784 |
| Practice Telephone | 5174234777 |
| Practice Fax Number | 5174237257 |
| Mailing Telephone | 5174234777 |
| Mailing Fax Number | 5174237257 |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2019-06-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
C-02189 | MI | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
6401010851 | MI | Behavioral Health & Social Service Providers |
| Y | 363A00000X | Physician Assistant | 5601008012 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MEDICARE PTAN | M35150147 | 01 |
| MI | 1194133082 | 05 |
| Street Address |
6869 S OCCIDENTAL RD |
| City | TECUMSEH |
| State | MI |
| Zip Code | 49286-9784 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003870031 | Laurie A Barkway | Emergency Medicine | 6869 S Occidental Rd, Tecumseh, MI 49286-9784 | 2006-04-14 |
| 1134745557 | Rachelle A Vanaken | Nurse Practitioner | 6869 S Occidental Rd, Tecumseh, MI 49286-9784 | 2020-06-22 |
| 1396378881 | Madeline Marie Petee | Nurse Practitioner | 6869 S Occidental Rd, Tecumseh, MI 49286-9784 | 2020-02-13 |
| 1427609312 | Promedica Central Corporation of Michigan | Clinic/Center | 6869 S Occidental Rd, Tecumseh, MI 49286-9784 | 2019-09-23 |
| 1205333689 | Sarah Beaulieu | Nurse Practitioner | 6869 S Occidental Rd, Tecumseh, MI 49286 | 2018-04-11 |
| 1275069957 | Deanna Louise Mcclain | Registered Nurse | 6869 S Occidental Rd, Tecumseh, MI 49286 | 2017-05-02 |
| 1922499789 | Rachael Hiller | Nurse Practitioner | 6869 S Occidental Rd, Tecumseh, MI 49286-9784 | 2015-02-13 |
| 1306126206 | Health Specialists of Lenawee | Family Medicine | 6869 S Occidental Rd, Tecumseh, MI 49286-9784 | 2011-08-23 |
| 1598918781 | Linda Sue Klavon | Nurse Practitioner | 6869 S Occidental Rd, Tecumseh, MI 49286-9784 | 2008-10-31 |
| 1467655852 | Kun Li | Family Medicine | 6869 S Occidental Rd, Tecumseh, MI 49286-9784 | 2007-06-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649706276 | Shivaay 1 Pllc | Pharmacy | 6869 S Occidental Highway, Tecumseh, MI 49286 | 2017-05-02 |
| 1386073658 | Leslie Ann Kovalski | Counselor | 2698 Burwyn Hills Drive, Tecumseh, MI 49286 | 2013-11-06 |
| 1629347364 | Carol A. Drayton | Social Worker | 308 South Maumee, Tecumseh, MI 49286 | 2011-12-27 |
| 1487931812 | Luann M Hurd | Counselor | 808 E. Chicago Blvd., Suite 14, Tecumseh, MI 49286 | 2011-11-14 |
| 1043596760 | Shawn R Gerrity | Physician Assistant | 501 E. Cummins St, Tecumseh, MI 49286 | 2011-10-26 |
| 1932331386 | Heidi Cunningham Herman | Social Worker | 2558 Dinius Rd, Tecumseh, MI 49286 | 2009-08-19 |
| 1417105560 | Nancy Grace Hornsby | Pharmacist | 2655 W. Chicago Blvd, Tecumseh, MI 49286 | 2008-09-03 |
| 1487822524 | James A Hinesly | Dentist | 126 Herrick Park Dr, Tecumseh, MI 49286 | 2008-02-12 |
| 1548442676 | Tecumseh Chiropractic Center, Incorporated | Chiropractor | 402 East Chicago Blvd., Tecumseh, MI 49286 | 2007-11-30 |
| 1740470509 | Todd Eduard Vonhofe | Chiropractor | 120 North Evans St., Tecumseh, MI 49286 | 2007-07-27 |
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| 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 |
|---|---|---|---|---|
| 1093356396 | Morgan Marie Monahan | Physician Assistant | 501 E Chicago Blvd, Tecumseh, MI 49286-1515 | 2019-10-08 |
| 1043596760 | Shawn R Gerrity | Physician Assistant | 501 E. Cummins St, Tecumseh, MI 49286 | 2011-10-26 |
| 1356413298 | Keith W. Clements | Physician Assistant | 292 Broadway St., Box 60, Tecumseh, NE 68450 | 2006-11-15 |
| 1649684184 | John Barrett Waldrep | Physician Assistant | 202 High St, Suite 100, Tecumseh, NE 68450-2443 | 2014-06-12 |
| 1659792968 | Kathryn Griess | Physician Assistant | 292 Broadway St, Tecumseh, NE 68450-2455 | 2014-01-05 |
| 1740548635 | Kelsey Lynn Perry | Physician Assistant | 501 E Cummins St, Tecumseh, MI 49286-2070 | 2012-04-27 |
| 1760623359 | Sara J Sharples | Physician Assistant | 509 Broadway St, Tecumseh, NE 68450-2306 | 2009-03-12 |
| 1205872777 | Angela L Diuble | Physician Assistant | 6869 S Occidental Rd, Tecumseh, MI 49286-9784 | 2006-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164022331 | Anna Lynn Shrift | Physician Assistant | 849 Black Hill Ln, Traverse City, MI 49696-8674 | 2020-10-27 |
| 1972102556 | Aaron Buckley | Physician Assistant | 567 Saint Louis St, Ferndale, MI 48220-2436 | 2020-10-23 |
| 1013516194 | Rebecca Mary Cronin | Physician Assistant | 4311 Kingsbrook Dr, Kalamazoo, MI 49006-3909 | 2020-10-20 |
| 1801495023 | Keriah Khairi Abd | Physician Assistant | 42836 Bloomingdale Dr, Sterling Heights, MI 48314-2843 | 2020-10-19 |
| 1154929016 | Angela Varghese | Physician Assistant | 461 Tanner Dr, Troy, MI 48085-4714 | 2020-10-13 |
| 1861090730 | Maloree Blayke Perkins | Physician Assistant | 20717 Coventry St, Clinton Twp, MI 48035-1603 | 2020-10-13 |
| 1801494000 | Sarah Puchala Lucero | Physician Assistant | 25614 Wilson Dr, Dearborn Heights, MI 48127-3427 | 2020-10-12 |
| 1871191007 | Julia Marie Tucker | Physician Assistant | 12250 E Ridge Dr, Bruce Twp, MI 48065-2011 | 2020-10-10 |
| 1164020301 | Sara Whitneyann Vandeman | Physician Assistant | 7901 S 12th St Ste 101, Portage, MI 49024-3831 | 2020-10-10 |
| 1831796267 | Jowharh Zindani | Physician Assistant | 12020 Mitchell St, Hamtramck, MI 48212-2722 | 2020-10-08 |
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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.