STEPHANIE REISDORF (NPI# 1225120967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225120967 |
| Entity Type | Individual |
| Full Name | STEPHANIE REISDORF |
| Credential | P.A. |
| Practice Address |
1201 Broad Rock Blvd Richmond VA 23249-0001 |
| Mailing Address |
15124 Watermill Lake Trl Midlothian VA 23112-4238 |
| Practice Telephone | 8016755000 |
| Mailing Telephone | 8047949148 |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2020-02-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0110002759 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
56010032523 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7200 Glen Forest Dr Ste 106, Richmond, VA 232263768 | 8044950053 | 7205980440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831526888 | Stephanie Reisdorf | Social Worker | 1515 E Tropicana Ave Ste 580, Las Vegas, NV 89119-6517 | 2013-10-06 |
| Street Address |
1201 BROAD ROCK BLVD |
| City | RICHMOND |
| State | VA |
| Zip Code | 23249-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780684480 | Earl M. Rogers I | Pharmacist | 1201 Broad Rock Blvd, Vamc Pharmacy Svc (119), Richmond, VA 23249-0001 | 2005-07-26 |
| 1750981791 | Irene Julia Montero | Recreation Therapist | 1201 Broad Rock Blvd, Richmond, VA 23249-0001 | 2020-10-29 |
| 1194325068 | Rodrick Dewayne Shinholster | Recreation Therapist | 1201 Broad Rock Blvd, Richmond, VA 23249-0001 | 2020-10-29 |
| 1902406887 | Akia Johnson | Recreation Therapist | 1201 Broad Rock Blvd, Richmond, VA 23249-0001 | 2020-10-29 |
| 1982204285 | Shaquana Shanesea Jones | Kinesiotherapist | 1201 Broad Rock Blvd, Richmond, VA 23249-0001 | 2020-10-27 |
| 1396345773 | Freda Sergi | Recreation Therapist | 1201 Broad Rock Blvd, Richmond, VA 23249-0001 | 2020-10-27 |
| 1548860091 | Curtis Antoine Robb | Recreation Therapist | 1201 Broad Rock Blvd, Richmond, VA 23249-0001 | 2020-10-26 |
| 1891394326 | Paulette Suzanne Beasley | Recreation Therapist | 1201 Broad Rock Blvd, Richmond, VA 23249-0001 | 2020-10-26 |
| 1104425636 | Jennifer Lee Vass | Recreation Therapist | 1201 Broad Rock Blvd, Richmond, VA 23249-0001 | 2020-10-26 |
| 1760099204 | Caitlyn Andree Pittman | Kinesiotherapist | 1201 Broad Rock Blvd, Richmond, VA 23249-0001 | 2020-09-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184010407 | Chris Dinh Nguyen | Internal Medicine | 1201 Broad Rock Blvd Richmond, Richmond, VA 23249 | 2015-04-14 |
| 1982049425 | Amy Nicole Whiffin | Emergency Medicine | 1201 Broad Rock Blvd. Emergency Department, Richmond, VA 23249 | 2013-05-09 |
| 1770786311 | Katherine Martin | Dentist | Mcguire Vamc Dental Service 1201 Broad Rock Blvd, Richmond, VA 23249 | 2007-06-11 |
| 1407922214 | Thomas Fagan | Pharmacist | 1201 Broadwalk Blvd, Richmond, VA 23249 | 2006-11-27 |
| 1922197474 | Rufus Anthony Harris | Social Worker | 1201 Broadrock Boulevard, Room 1e 114, Richmond, VA 23249 | 2006-10-12 |
| 1497848386 | Patricia S Kelly | Religious Nonmedical Nursing Personnel | 1201 Brock Roack Blvd., Richmond, VA 23249 | 2006-10-02 |
| 1073619938 | Deborah Walck Haynes | Physician Assistant | Mcguire Va Medical Center, 1201 Broad Rock Blvd. (151), Richmond, AL 23249 | 2006-09-16 |
| 1932204682 | James Kenneth Schmitt | Internal Medicine | 1201 Broadrock Rd, Richmond, VA 23249 | 2006-09-14 |
| 1679675045 | Ida Foster | Family Medicine | 1801 Broad Rock Boulevard, Richmond, VA 23249 | 2006-09-05 |
| 1871607176 | James Luther Tatum | Nuclear Medicine | 1201 Broadrock Road, Richmond, VA 23249 | 2006-08-17 |
| Find all providers in zip 23249 | ||||
| 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 |
|---|---|---|---|---|
| 1467050633 | Timothy Jacob Simpson | Physician Assistant | 113 S Davis Ave Apt 6105, Richmond, VA 23220-5156 | 2020-10-11 |
| 1205433885 | Jackson Laboue | Physician Assistant | 3510 Archer Springs Ter, Richmond, VA 23235-2163 | 2020-10-06 |
| 1306460316 | Humaira Farukh | Physician Assistant | 13903 Carncross Ct, Richmond, TX 77407-1007 | 2020-06-04 |
| 1609413640 | Abigail Marie Stone | Physician Assistant | 16 N Vine St Apt 213, Richmond, VA 23220-4565 | 2019-12-10 |
| 1881241305 | Lauren Elizabeth Desroches | Physician Assistant | 7101 Jahnke Rd # 205, Richmond, VA 23225-4017 | 2019-08-20 |
| 1720633530 | Sabrina Chica | Physician Assistant | 7405 Montrose Ave, Richmond, VA 23227-1808 | 2019-08-08 |
| 1235790569 | Emma Katherine Cahoon | Physician Assistant | 20 Chelsea Farm Dr, Richmond, RI 02898-1221 | 2019-06-26 |
| 1699249615 | Kendra Ray Long | Physician Assistant | 9119 Stony Point Pkwy Apt 4203, Richmond, VA 23235-2076 | 2019-01-12 |
| 1578045993 | Lauren Jernegan | Physician Assistant | 204 S Mulberry St, Richmond, VA 23220 | 2018-09-01 |
| 1164954590 | Allyson Hudson Saunders | Physician Assistant | 7101 Jahnke Rd., Suite # 260, Richmond, VA 23225 | 2017-04-03 |
| Find all providers in RICHMOND | ||||
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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.