JOREL DICKINSON-HENDERSHOT (NPI# 1376781005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376781005 |
| Entity Type | Individual |
| Full Name | JOREL DICKINSON-HENDERSHOT |
| Credential | CRNA |
| Practice Address |
1 N Atkinson Dr Ludington MI 49431-1906 |
| Mailing Address |
1701 Lake Lansing Rd Suite 100 Lansing MI 48912-3798 |
| Practice Telephone | 2318452348 |
| Mailing Telephone | 5174850001 |
| Mailing Fax Number | 5174851138 |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2009-02-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | JD245092 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1 N ATKINSON DR |
| City | LUDINGTON |
| State | MI |
| Zip Code | 49431-1906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972589489 | Memorial Medical Center of West Michigan | General Acute Care Hospital | 1 N Atkinson Dr, Ludington, MI 49431-1906 | 2005-12-16 |
| 1033505128 | Spectrum Health | Non-Pharmacy Dispensing Site | 1 N Atkinson Dr, Ludington, MI 49431-1906 | 2015-04-15 |
| 1508260902 | Memorial Medical Center of West Michigan | Family Medicine | 1 N Atkinson Dr, Ludington, MI 49431-1906 | 2014-10-14 |
| 1629481502 | Spectrum Health Primary Care Partners | Internal Medicine | 1 N Atkinson Dr, Ludington, MI 49431-1906 | 2014-06-09 |
| 1477966489 | West Michigan Heart | Internal Medicine | 1 N Atkinson Dr, Ludington, MI 49431-1906 | 2014-06-06 |
| 1326481847 | Brian Lindenborn | Nurse Anesthetist, Certified Registered | 1 N Atkinson Dr, Ludington, MI 49431-1906 | 2013-04-15 |
| 1790025500 | Indigo Hospital Medicine - Ludington, Plc | Family Medicine | 1 N Atkinson Dr, Ludington, MI 49431-1906 | 2013-02-15 |
| 1215280722 | Robert Paul Olson | Nurse Anesthetist, Certified Registered | 1 N Atkinson Dr, Ludington, MI 49431-1906 | 2012-10-22 |
| 1538324553 | Iman Henry Zeidan | Family Medicine | 1 N Atkinson Dr, Ludington, MI 49431-1906 | 2008-07-21 |
| 1457524019 | Christa W Lenz | Dietitian, Registered | 1 N Atkinson Dr, Ludington, MI 49431-1906 | 2008-04-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972006690 | Marti Miller | Physical Therapist | 5916 Iris Rd., Ludington, MI 49431 | 2018-03-09 |
| 1700258670 | Leslie Hahn Ezdebski | Registered Nurse | 318 River St., Suite B, Manistee, MI 49431 | 2015-10-30 |
| 1477888618 | Kathleen M Tooman | Orthotic Fitter | 901 E Tinkham Avenue, Ludington, MI 49431 | 2009-10-06 |
| 1790831592 | Roger Edgren Ostling | Social Worker | 1027 N Rath, Ludington, MI 49431 | 2007-01-25 |
| 1487734364 | Kathryn Jean Niemeyer | Nurse Practitioner | 5 Atkinson Drive, Suite #207, Ludington, MI 49431 | 2006-10-16 |
| 1609986405 | Vivek Thakore | Clinic/Center | 5511 West Us 10 Hwy, Ludington, MI 49431 | 2006-08-30 |
| 1295747756 | Barbara Sleder | Nurse Practitioner | 1 North Atkinson Dr, Ludington, MI 49431 | 2006-08-13 |
| 1083653893 | William L Ingle Dc | Chiropractor | 321 N Jebavy Drive, Ludington, MI 49431 | 2006-06-06 |
| 1366429706 | Andrew S Riemer | Ophthalmology | 5959 Lawndale St, Ludington, MI 49431 | 2005-12-28 |
| 1699240085 | Toby Wessel, Lmsw, Pllc | Social Worker | 612 Sherman Oaks Dr, Ludington, MI 49431 | 2018-10-11 |
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| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (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. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326481847 | Brian Lindenborn | Nurse Anesthetist, Certified Registered | 1 N Atkinson Dr, Ludington, MI 49431-1906 | 2013-04-15 |
| 1215280722 | Robert Paul Olson | Nurse Anesthetist, Certified Registered | 1 N Atkinson Dr, Ludington, MI 49431-1906 | 2012-10-22 |
| 1821314378 | Luke J Bootz | Nurse Anesthetist, Certified Registered | 1 Atkinson Dr, Ludington, MI 49431-1906 | 2010-04-08 |
| 1598815102 | Robert A Leitelt | Nurse Anesthetist, Certified Registered | 1 N Atkinson Dr, Ludington, MI 49431-1906 | 2007-01-12 |
| 1669531968 | Richard D Pitt | Nurse Anesthetist, Certified Registered | 1 N Atkinson Dr, Ludington, MI 49431-1906 | 2006-12-06 |
| 1568534063 | Anesthesia Associates of West Michigan, PC | Nurse Anesthetist, Certified Registered | 1 N Atkinson Dr, Ludington, MI 49431-1906 | 2006-11-14 |
| 1295807709 | Clark Fritton | Nurse Anesthetist, Certified Registered | 1 N Atkinson Dr, Ludington, MI 49431-1906 | 2006-11-14 |
| 1104998681 | Charles D White | Nurse Anesthetist, Certified Registered | 1 N Atkinson Dr, Ludington, MI 49431-1906 | 2006-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615986 | Toleka Regina Taylor | Nurse Anesthetist, Certified Registered | St. John Macomb Hospital, 11800 East 12 Mile Road, Warren, MI 48093 | 2020-10-05 |
| 1245850957 | Black River Anesthesia Staffing LLC | Nurse Anesthetist, Certified Registered | 7245 Baseline Rd, South Haven, MI 49090-9176 | 2020-04-22 |
| 1669008017 | Kalin Elizabeth Wade | Nurse Anesthetist, Certified Registered | 4485 Kenneth Dr Apt C207, Okemos, MI 48864-1900 | 2020-03-18 |
| 1215568340 | Complete Ketamine Inc | Nurse Anesthetist, Certified Registered | 98 Winchester St, Monroe, MI 48161-1957 | 2020-01-28 |
| 1730729740 | Pride Mudzwova | Nurse Anesthetist, Certified Registered | 57693 Dakota Dr, New Hudson, MI 48165-9336 | 2020-01-08 |
| 1982249041 | Leif Elias | Nurse Anesthetist, Certified Registered | 3443 Oak Dr, Ann Arbor, MI 48105-9798 | 2019-11-13 |
| 1619512779 | Yvonne Marie Bridgeford | Nurse Anesthetist, Certified Registered | 2113 Mason Rd, Howell, MI 48843-8903 | 2019-11-13 |
| 1184269243 | Jaclyn Rochefort | Nurse Anesthetist, Certified Registered | 5381 Frovan Pl, Saginaw, MI 48638-5573 | 2019-11-13 |
| 1932744091 | Sean S Vanderwaal | Nurse Anesthetist, Certified Registered | 1420 Perry Rd Apt 1-8, Grand Blanc, MI 48439-1727 | 2019-11-13 |
| 1467093153 | Apollo Medical Group of Traverse City Pllc | Nurse Anesthetist, Certified Registered | 3663 N Country Dr, Traverse City, MI 49684-4587 | 2019-10-03 |
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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.