JACK SIEBENALER II MD, INC (NPI# 1255514873) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255514873 |
| Entity Type | Organization |
| Organization Name | JACK SIEBENALER II MD, INC |
| Practice Address |
3232 Navarre Ave Oregon OH 43616-3312 |
| Practice Telephone | 4196910636 |
| Practice Fax Number | 4196931412 |
| Mailing Telephone | 4196910636 |
| Mailing Fax Number | 4196931412 |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2012-02-22 |
| Authorized Official Name | DR. JACK G SIEBENALER II (OWNER) |
| Authorized Official Telephone | 4196910636 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
350535801S | OH | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0056057 | 05 |
| Street Address |
3232 NAVARRE AVE |
| City | OREGON |
| State | OH |
| Zip Code | 43616-3312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982670212 | Jack Siebenaler II | Family Medicine | 3232 Navarre Ave, Oregon, OH 43616-3312 | 2006-02-27 |
| 1861743924 | Hallett Enterprises, LLC | Physical Therapist | 3232 Navarre Ave, Oregon, OH 43616-3312 | 2012-09-28 |
| 1275842700 | Judith A. Schuessler | Nurse Practitioner | 3232 Navarre Ave, Oregon, OH 43616-3312 | 2010-10-01 |
| 1083852719 | Debra L Hansen | Nurse Practitioner | 3232 Navarre Ave, Oregon, OH 43616-3312 | 2009-02-03 |
| 1013047711 | Kelly M Sadowski | Physician Assistant | 3232 Navarre Ave, Oregon, OH 43616-3312 | 2007-03-06 |
| 1790822948 | Theresa Ann Lohman | Nurse Practitioner | 3232 Navarre Ave, Oregon, OH 43616-3312 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699273086 | Tamara Dawson-kynard | Case Manager/Care Coordinator | 40 S Wheeling St, Oregon, OH 43616 | 2018-01-31 |
| 1053703728 | Robert Cousino | Technician | 3018 Springwood St. S, Oregon, OH 43616 | 2015-03-04 |
| 1023359502 | Enrich Medical Transoportation | Non-emergency Medical Transport (VAN) | 1041 Ansonia St, Oregon, OH 43616 | 2013-03-08 |
| 1265779284 | Kathleen C Pollauf | Massage Therapist | 2665 Navarre Ave, Suite A, Oregon, OH 43616 | 2013-01-10 |
| 1225318389 | Tanuja Shekhawat | Dentist | 3246 Navarre Ave., Oregon, OH 43616 | 2011-08-22 |
| 1932408622 | Lisa Marie Coughlin | Surgery | 2751 Bay Park Dr Ste 300-303, Oregon, OH 43616 | 2011-03-21 |
| 1356598940 | Ranvir Singh Rathore | Internal Medicine | 3841 Navarre Avenue, Oregon, OH 43616 | 2008-08-26 |
| 1114182276 | Jennifer Pfleghaar | Emergency Medicine | 2600 Navarre Avenue, Oregon, OH 43616 | 2008-07-28 |
| 1437318938 | Kelly C Mcgee | Nurse Practitioner | 3301 Navarne Avenue, Oregon, OH 43616 | 2008-06-09 |
| 1083712509 | Colony Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 2701 Navarre, Oregon, OH 43616 | 2006-09-20 |
| Find all providers in zip 43616 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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|---|---|---|---|---|
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| 1952403776 | Maumee Bay Family Practice, Inc. | Clinic/Center | 4330 Navarre Ave, Suite 103, Oregon, OH 43616-3578 | 2006-09-02 |
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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.