MRS. CONNIE BAKER KLOTZBACH (NPI# 1225576820) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225576820 |
| Entity Type | Individual |
| Full Name | MRS. CONNIE BAKER KLOTZBACH |
| Credential | PA-C |
| Practice Address |
2819 Denny Ave Pascagoula MS 39581-5301 |
| Mailing Address |
13 54th St Gulfport MS 39507-4602 |
| Practice Telephone | 2288189620 |
| Mailing Telephone | 2288062288 |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2017-02-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA00315 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2819 DENNY AVE |
| City | PASCAGOULA |
| State | MS |
| Zip Code | 39581-5301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770585630 | Robert L Donald IIi | Family Medicine | 2819 Denny Ave, Pascagoula, MS 39581-5301 | 2005-08-11 |
| 1376186734 | Taylor Kathleen Little | Nurse Practitioner | 2819 Denny Ave, Pascagoula, MS 39581-5301 | 2019-10-17 |
| 1336674803 | Matthew Bosarge | Family Medicine | 2819 Denny Ave, Pascagoula, MS 39581-5301 | 2017-04-21 |
| 1134495443 | Ashley N Hilsabeck | Nurse Practitioner | 2819 Denny Ave, Pascagoula, MS 39581-5301 | 2012-03-30 |
| 1609926211 | Martin Bydalek | Emergency Medicine | 2819 Denny Ave, Pascagoula, MS 39581 | 2007-01-12 |
| 1346266921 | South Coast Family Physicians | Legal Medicine | 2819 Denny Ave, Pascagoula, MS 39581-5301 | 2006-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760945448 | Jacquelyn B Ellison | Nurse Practitioner | 4105 Hospital Road, Ste 103, Pascagoula, MS 39581 | 2019-04-10 |
| 1104346816 | Jennifer Ngoc Bui | Dentist | 4001 Denny Ave Suite 1, Pascagoula, MS 39581 | 2017-06-23 |
| 1528486289 | Thomas Stallworth | Nurse Practitioner | 4105 Hospital St Ste 104, Pascagoula, MS 39581 | 2014-03-31 |
| 1487919957 | Candace Noel Pendowski | Nurse Practitioner | 4211 Hospital St Suite 208, Pascagoula, MS 39581 | 2012-07-10 |
| 1649548892 | Kim M. Tumminello | Nurse Practitioner | 4253 Denny Avenue, Pascagoula, MS 39581 | 2011-12-02 |
| 1649547860 | Abrian Norell Flowers | Physical Therapist | 3537 Denny Avenue, Suite 115, Pascagoula, MS 39581 | 2011-11-17 |
| 1164724118 | Coast To Coast Rehab LLC | Rehabilitation Practitioner | 3537 Denny Ave, Suite 115, Pascagoula, MS 39581 | 2010-11-24 |
| 1740500958 | Joshua Eric Tucker | Physical Medicine & Rehabilitation | 4105 Hospital St Ste 112b, Pascagoula, MS 39581 | 2010-06-10 |
| 1720164916 | Vernon W Doster | Family Medicine | 3616 Hospital Street, Suite D, Pascagoula, MS 39581 | 2006-10-31 |
| 1841387727 | David Bruce Allen | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4300 Hospital Rd, Suite 105, Pascagoula, MS 39581 | 2006-10-10 |
| Find all providers in zip 39581 | ||||
| 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 |
|---|---|---|---|---|
| 1649871682 | Katherine Rae Herndon | Physician Assistant | 2525 Telephone Rd, Pascagoula, MS 39567-3202 | 2020-11-05 |
| 1083124143 | Alejandra Diaz | Physician Assistant | 2525 Telephone Rd, Pascagoula, MS 39567-3202 | 2017-10-03 |
| 1356796577 | Madison Avara Brown | Physician Assistant | 4105 Hospital St Ste 112b, Pascagoula, MS 39581-5304 | 2016-04-25 |
| 1093139040 | Complete Health Urgicare, Inc | Physician Assistant | 4211 Hospital St, Suite 101, Pascagoula, MS 39581-5320 | 2014-02-11 |
| 1598016701 | Allison A Garstecki | Physician Assistant | 4105 Hospital St, Suite 112b, Pascagoula, MS 39581-5312 | 2012-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831703958 | Melanie Layne Mccoy | Physician Assistant | 202 Joyce Ave, Long Beach, MS 39560-4332 | 2020-09-04 |
| 1437785482 | Kimberly Jordan Tupper | Physician Assistant | 6371 Shenandoah Ln, Olive Branch, MS 38654-3425 | 2020-03-20 |
| 1700419041 | Alexander Sorokin Flecker | Physician Assistant | 200b Eager St, Clinton, MS 39056-4545 | 2020-02-14 |
| 1548892904 | Meghan Seymour | Physician Assistant | 510 Glensview Dr, Brandon, MS 39047-7919 | 2020-02-04 |
| 1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
| 1477190668 | Kimberly Mcraney Watson | Physician Assistant | 907 Oakhill Cir, Clinton, MS 39056-3743 | 2019-12-06 |
| 1598301632 | Daniel Edward Bloom | Physician Assistant | Naval Branch Health Clinic Gulfport, 5502 Marvin Shields Blvd, Gulfport, MS 39501 | 2019-11-25 |
| 1467097956 | Chandler Stengel | Physician Assistant | 7900 Airways Blvd., Ste B102, Southaven, MS 38671-5809 | 2019-11-08 |
| 1922653526 | Lauren Ramsey | Physician Assistant | 845 E Scenic Dr, Pass Christian, MS 39571-4624 | 2019-08-09 |
| 1972161891 | Allison Taylor | Physician Assistant | 1850 Chadwick Drive, Suite 1427, North Tower, 4 West, Jackson, MS 39204-3404 | 2019-06-05 |
| Find all providers with the same taxonomy | ||||
| City | PASCAGOULA |
| Zip Code | 39581 |
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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.