JEFFREY ROBERT FLACK (NPI# 1275855231) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275855231 |
| Entity Type | Individual |
| Full Name | JEFFREY ROBERT FLACK |
| Credential | PA-C, ATC |
| Practice Address |
890 W Elliot Rd Suite 103 Gilbert AZ 85233-5102 |
| Practice Telephone | 4802144466 |
| Mailing Telephone | 4802144466 |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2014-06-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
0090 | AZ | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 363A00000X | Physician Assistant | 5473 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821278268 | Jeffrey S Flack | Physical Therapy Assistant | 1507 7th St, Lincoln, IL 62656-2216 | 2007-11-13 |
| Street Address |
890 W ELLIOT RD SUITE 103 |
| City | GILBERT |
| State | AZ |
| Zip Code | 85233-5102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124008016 | Toni Denise Muckala | Pharmacist | 890 W Elliot Rd, Gilbert, AZ 85233-5102 | 2006-01-18 |
| 1073024675 | Jennifer Renee Kolle | Physician Assistant | 890 W Elliot Rd, Gilbert, AZ 85233-5102 | 2017-10-23 |
| 1922553742 | Laura Elizabeth Bohning | Physician Assistant | 890 W Elliot Rd, #102, Gilbert, AZ 85233-5102 | 2016-08-22 |
| 1699229112 | Boden Bradley | Physician Assistant | 890 W Elliot Rd, Suite 107, Gilbert, AZ 85233-5102 | 2016-08-12 |
| 1720438682 | Mckenzie Siemion | Nurse Practitioner | 890 W Elliot Rd, Gilbert, AZ 85233-5102 | 2016-06-21 |
| 1982083317 | Julie Hinman | Nurse Practitioner | 890 W Elliot Rd, Suite 102, Gilbert, AZ 85233-5102 | 2015-05-19 |
| 1407246689 | Gregory Best | Registered Nurse | 890 W Elliot Rd, Suite 102, Gilbert, AZ 85233-5102 | 2015-01-27 |
| 1861881351 | Sylvania Hernandez-latog | Nurse Practitioner | 890 W Elliot Rd, Suite 102, Gilbert, AZ 85233-5102 | 2015-01-21 |
| 1417359597 | Robin Huesgen | Nurse Practitioner | 890 W Elliot Rd, Suite 103, Gilbert, AZ 85233-5102 | 2014-09-21 |
| 1629479621 | Nathan Cook | Physician Assistant | 890 W Elliot Rd, Ste 102, Gilbert, AZ 85233-5102 | 2014-09-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467063594 | Specialized Education of Arizona, Inc. | Day Training, Developmentally Disabled Services | 875 S. Coooper Rd., Gilbert, AZ 85233 | 2020-08-12 |
| 1336649425 | Jason Diminico | Behavior Technician | 82 W Gilbert Road, Gilbert, AZ 85233 | 2018-02-15 |
| 1508378274 | L & S Az L.L.C. | Family Medicine | 201 W. Guadalupe Rd #102, Gilbert, AZ 85233 | 2017-11-02 |
| 1740799022 | Angel Day Care LLC | Clinic/Center | 815 W Wagner Ct, Gilbert, AZ 85233 | 2017-09-29 |
| 1235656356 | Jason Karstens | Physical Therapist | 1447 West Elliot Road, Suite 101, Gilbert, AZ 85233 | 2017-08-29 |
| 1538684956 | Independent By Design, Pllc | Occupational Therapy Assistant | 835 W Warner Rd Suite 101 - 623, Gilbert, AZ 85233 | 2017-08-07 |
| 1619406998 | Marri Keller | Physical Therapist | 690 Copper Rd, Suite 101, Gilbert, AZ 85233 | 2017-06-08 |
| 1538692470 | Ocotillo Medical Group LLC | Chiropractor | 2815 E. Ocotillo Rd, #4, Chandler, AZ 85233 | 2017-04-07 |
| 1922544634 | Riann Naomi Simmons | Nurse Practitioner | 800 W Elliot Road, Suite 103, Gilbert, AZ 85233 | 2017-01-19 |
| 1154793685 | Laura Beth Masters | Nurse Practitioner | Shelley Staymates, 890 W Elliott #120, Gilbert, AZ 85233 | 2015-10-23 |
| Find all providers in zip 85233 | ||||
| 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 |
|---|---|---|---|---|
| 1427687953 | Zachary Scott | Physician Assistant | 562 E Campbell Ave, Gilbert, AZ 85234-4612 | 2020-04-06 |
| 1912539511 | Amber Lee Price | Physician Assistant | 428 S Gilbert Rd Ste 114, Gilbert, AZ 85296-2262 | 2020-02-11 |
| 1912549379 | Brooke Elizabeth Lopez | Physician Assistant | 1489 S Higley Rd Ste 101, Gilbert, AZ 85296-4777 | 2019-10-16 |
| 1477118180 | Mai Thai | Physician Assistant | 1725 S Coronado Rd Apt 1035, Gilbert, AZ 85295-0080 | 2019-05-08 |
| 1356800924 | Kirstin Lampi Tymkew | Physician Assistant | 4255 E Pecos Rd Apt 3011, Gilbert, AZ 85295-7842 | 2019-03-13 |
| 1033685763 | Jocelyn Lucita Ore | Physician Assistant | 3011 S Lindsay Rd Ste 105, Gilbert, AZ 85295-4333 | 2018-10-20 |
| 1003381633 | Samuel Dean Fox | Physician Assistant | 4915 E Baseline Rd Ste 102, Gilbert, AZ 85234-2966 | 2018-10-10 |
| 1598240731 | Sylvia Phommalinh | Physician Assistant | 1309 S Minneola Ln, Gilbert, AZ 85296-7824 | 2018-10-03 |
| 1518441831 | Kara Lyn Holyoak | Physician Assistant | 1359 S. Porter St., Gilbert, AZ 85296 | 2018-09-21 |
| 1144703257 | Annie Celeste Hart | Physician Assistant | 610 W Sereno Dr, Gilbert, AZ 85233-7251 | 2018-09-13 |
| Find all providers in GILBERT | ||||
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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.