MACKENZIE MOORE VILLARREAL (NPI# 1386092377) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386092377 |
| Entity Type | Individual |
| Full Name | MACKENZIE MOORE VILLARREAL |
| Credential | PA |
| Practice Address |
202 Ridge Ln Ashland PA 17921-8318 |
| Mailing Address |
202 Ridge Lane Ashland PA 17921 |
| Practice Telephone | 5705900241 |
| Mailing Telephone | 5705900241 |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2016-05-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
202 RIDGE LN |
| City | ASHLAND |
| State | PA |
| Zip Code | 17921-8318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093933749 | Gaudenzia Inc | Clinic/Center | 91 Broad Street, Ashland, PA 17921 | 2007-04-20 |
| 1124193743 | John William Stefovic | General Practice | 530 Centre Street, Ashland, PA 17921 | 2006-11-21 |
| 1063594570 | John E Wolfgang | Chiropractor | 1028 Centre Street, Ashland, PA 17921 | 2006-10-20 |
| 1043204670 | Concept Pharmacy Services LLC | Durable Medical Equipment & Medical Supplies | 639 Chestnut St, Ashland, PA 17921 | 2005-09-09 |
| 1295998169 | Jason John Clarity | Internal Medicine | 101 Broad St., St. Catherine Medical Center, Ashland, PA 17921 | 2008-07-09 |
| 1649339383 | Mark David Gernerd | Emergency Medicine | 101 Broad Street, Saint Catherine Medical Center Fountain Springs, Ashland, PA 17921 | 2006-12-08 |
| 1174176796 | Cornerstone Coordinated Health Care, LLC | Clinic/Center | 2114 Centre St, Ashland, PA 17921-1015 | 2019-07-23 |
| 1215247846 | Kimberly Kay Walacavage | Occupational Therapist | 2130 Centre St, Ashland, PA 17921-1015 | 2010-10-17 |
| 1720611726 | Cornerstone Coordinated Health Care, LLC | Family Medicine | 2114 Centre St, Ashland, PA 17921-1015 | 2020-02-18 |
| 1164414934 | Washington Fire Company and Community Ambulance | Ambulance | 1309 W Center St, Ashland, PA 17921-1102 | 2005-08-18 |
| Find all providers in zip 17921 | ||||
| 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 |
|---|---|---|---|---|
| 1417575473 | Hemal Kishorbhai Desai | Physician Assistant | 1 Cirrus Dr Apt 105, Ashland, MA 01721-4431 | 2020-07-07 |
| 1770104408 | Logan Leon | Physician Assistant | 404 Lakeshore Rd, Ashland, OH 44805-8612 | 2020-05-05 |
| 1083165559 | Ashland Hospital Corporation | Physician Assistant | 14375 Lions Ln, Ashland, KY 41102-7066 | 2016-10-20 |
| 1508317975 | Ashland Hospital Corporation | Physician Assistant | 2123 Main St W, Ashland, KY 41102-3237 | 2016-10-20 |
| 1407307879 | Ashland Hospital Corporation | Physician Assistant | 1001 Winslow Rd, Ashland, KY 41102-5317 | 2016-10-20 |
| 1891246369 | Ashland Hospital Corporation | Physician Assistant | 1226 Summitt Rd, Ashland, KY 41102-8278 | 2016-10-20 |
| 1598216962 | Ashland Hospital Corporation | Physician Assistant | 258 Mcknight St, Ashland, KY 41102-4339 | 2016-10-20 |
| 1437600814 | Ashland Hospital Corporation | Physician Assistant | 3215 South 29th St, Ashland, KY 41102 | 2016-10-20 |
| 1437600905 | Ashland Hospital Corporation | Physician Assistant | 12862 State Route 180, Ashland, KY 41102-8939 | 2016-10-20 |
| 1174074553 | Ashland Hospital Corporation | Physician Assistant | 1100 Bob Mccullough Dr, Ashland, KY 41102 | 2016-10-20 |
| Find all providers in ASHLAND | ||||
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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.