ANDREA CLEGG (NPI# 1285612861) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1285612861 |
Entity Type | Individual |
Full Name | ANDREA CLEGG |
Credential | NP |
Practice Address |
18101 Oakwood Blvd Ste 101 Dearborn MI 48124-4089 |
Practice Telephone | 3139967280 |
Mailing Telephone | 3139967280 |
Enumeration Date | 2006-01-04 |
Last Update Date | 2011-08-25 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 4704218011 | MI | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MI | 10-4773406 | 05 | |
CAQH | 11712499 | 01 | |
MI | 10-4773371 | 05 | |
MI | 10-4773380 | 05 | |
MI | 11-4941047 | 05 | |
MI | 10-4773362 | 05 | |
MI | 10-4773390 | 05 | |
MI | 11-4941038 | 05 | |
MI | 11-4941065 | 05 | |
RAILROAD MEDICARE | P00380696 | 01 | |
MI | 11-4941056 | 05 | |
MI | BCBS | 5008604240 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164854378 | Andrea Marie Clegg | Dentist | 432 Heron Pl, Davis, CA 95616-7512 | 2013-07-30 |
1689932212 | Andrea J Clegg | Specialist/Technologist | 201 E Germantown Pike, Plymouth Meeting, PA 19462-1550 | 2012-05-02 |
Street Address |
18101 OAKWOOD BLVD STE 101 |
City | DEARBORN |
State | MI |
Zip Code | 48124-4089 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396389524 | Pharma A, LLC | Pharmacy | 23916 Michigan Ave, Dearborn, MI 48124 | 2019-10-31 |
1225683725 | Aysha Said | Behavior Technician | 1369 Porter St, Dearborn, MI 48124 | 2019-08-02 |
1881257772 | Leen Nusairat | Internal Medicine | Beaumont Health-dearborn Campus, 18101 Oakwood Blvd, Dearborn, MI 48124 | 2019-04-17 |
1417413360 | Gary C. Veraghen, Dds, PC | Dentist | 22100 W. Outer Drive, Dearborn, MI 48124 | 2019-02-15 |
1982168787 | Fnu Asma Manzar | Physical Therapist | Global Physical Therapy Services, Inc, 22819 Michigan Avenue, Dearborn, MI 48124 | 2019-01-25 |
1639640162 | Jernia Lashawn Usher | Behavior Technician | 1360 Porter St Lower Level, Dearborn, MI 48124 | 2018-12-10 |
1710456470 | Samar Fouad Hannawi | Psychologist | 3815 Pelham Street, Suite #13, Dearborn, MI 48124 | 2018-11-24 |
1881178747 | Sarah Chehab | Psychologist | 835 Mason St Suite 220b, Dearborn, MI 48124 | 2018-09-17 |
1568948289 | Ibrahim M Basma | Pharmacist | 22521 Michigan Avenue, Dearborn, MI 48124 | 2018-07-16 |
1669961942 | Jacqueline E Domzalski | Technician, Other | 3231 S. Gulley, Suite E, Dearborn, MI 48124 | 2018-05-02 |
Find all providers in zip 48124 |
Taxonomy Code | 363L00000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497234066 | Tristan Murray | Nurse Practitioner | 5901 Chase Rd, Dearborn, MI 48126-0900 | 2018-08-14 |
1811404312 | Tracey Marie Michels | Nurse Practitioner | 3133 S. Telegraph, Dearborn Family Clinic, Dearborn, MI 48124 | 2018-01-05 |
1386676195 | Christine Giska Westphal | Nurse Practitioner | 18101 Oakwood, Suite 126, Dearborn, MI 48123-2500 | 2006-07-06 |
1730186537 | Ann Marie Edwards | Nurse Practitioner | 18100 Oakwood Blvd Ste 213, Dearborn, MI 48124-4085 | 2005-07-07 |
1346871191 | Tamela Lynn Lassila | Nurse Practitioner | 5250 Auto Club Dr Ste 200, Dearborn, MI 48126-2619 | 2020-01-30 |
1871124974 | Kimberlee Erison | Nurse Practitioner | 3850 Pelham St, Dearborn, MI 48124-3832 | 2020-01-28 |
1760022057 | Timothy Patrick Corcoran | Nurse Practitioner | 6050 Greenfield Rd Ste 101, Dearborn, MI 48126-6004 | 2020-01-14 |
1225699911 | Andrew Joseph Plaza | Nurse Practitioner | 18101 Oakwood Blvd, Dearborn, MI 48124-4089 | 2019-06-24 |
1639733298 | Stephanie Elizabeth Castaing | Nurse Practitioner | 1537 Monroe St, Dearborn, MI 48124-2842 | 2019-04-29 |
1912469701 | Bilal Abdulla | Nurse Practitioner | 5245 Schaefer Rd Ste D, Dearborn, MI 48126-3257 | 2019-04-02 |
Find all providers in DEARBORN |
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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.