MITCHELL S MCTAVISH (NPI# 1386156891) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386156891 |
| Entity Type | Individual |
| Full Name | MITCHELL S MCTAVISH |
| Credential | PA-C |
| Practice Address |
1600 Coraopolis Heights Rd Ste E Moon Township PA 15108-4316 |
| Mailing Address |
11279 Perry Hwy Ste 450 Wexford PA 15090-9303 |
| Practice Telephone | 4122622415 |
| Practice Fax Number | 4122621537 |
| Mailing Telephone | 7249331100 |
| Mailing Fax Number | 7249331160 |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2017-10-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
MA059239 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1600 CORAOPOLIS HEIGHTS RD STE E |
| City | MOON TOWNSHIP |
| State | PA |
| Zip Code | 15108-4316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568431757 | Amy Landis | Nurse Practitioner | 1600 Coraopolis Heights Rd Ste E, Moon Township, PA 15108-4316 | 2006-03-17 |
| 1386158400 | Jenna E Muraco | Nurse Practitioner | 1600 Coraopolis Heights Rd Ste E, Moon Township, PA 15108-4316 | 2017-11-28 |
| 1134631245 | Brian Casey | Physician Assistant | 1600 Coraopolis Heights Rd Ste E, Moon Township, PA 15108-4316 | 2017-10-30 |
| 1063429678 | Childen's Community Care | Pediatrics | 1600 Coraopolis Heights Rd Ste E, Moon Township, PA 15108-4316 | 2006-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215550082 | Erin Larue | Counselor | 1010 Brodhead Rd., 2nd Floor, Moon Township, PA 15108 | 2020-05-27 |
| 1457986721 | Favored Wellness Counseling and Consulting, LLC | Counselor | 1010 Broadhead Road, 2nd Floor, Moon Township, PA 15108 | 2020-03-07 |
| 1023597937 | Jessica Marie Neff | Pharmacist | 217 Beagle Drive, Moon Township, PA 15108 | 2018-08-10 |
| 1992281125 | Aurora Recovery Services, LLC | Family Medicine | 993 Brodhead Rd Ste 201, Moon Twp, PA 15108 | 2018-07-11 |
| 1134611916 | Michaela Marie Stubna | Occupational Therapy Assistant | 54 Long Valley, Coraopolis, PA 15108 | 2018-06-06 |
| 1063924520 | Tammy Lynne Rink | Counselor | 1555 Brodhead Rd, Moon Township, PA 15108 | 2017-10-24 |
| 1194243584 | Anthony Joseph Decarlo | Specialist/Technologist | 48 Laurel Ridge Rd, Coraopolis, PA 15108 | 2017-09-06 |
| 1114479102 | Daniel R Fuller Jr. | Pharmacist | 7500 Univsersity Blvd., Moon Township, PA 15108 | 2016-10-26 |
| 1043768823 | Kelsey Kelleher | Physical Therapist | 100 Corporate Center Dr Ste 115, Coraopolis, PA 15108 | 2016-09-21 |
| 1518325208 | Elizabeth Thomeier Dornetto | Counselor | 993 Brodhead Rd Ste 203, Coraopolis, PA 15108 | 2016-02-09 |
| Find all providers in zip 15108 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134631245 | Brian Casey | Physician Assistant | 1600 Coraopolis Heights Rd Ste E, Moon Township, PA 15108-4316 | 2017-10-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497355341 | Julia Majewicz Wilson | Physician Assistant | 111 Pa-715, #102, Brodheadsville, PA 18322 | 2020-10-29 |
| 1417557273 | Jared Michael Yon | Physician Assistant | 902 Dale Ave, Bradfordwoods, PA 15015-1236 | 2020-10-29 |
| 1295335230 | Jillian Ann Korgeski | Physician Assistant | 400 Corner St, Dunmore, PA 18512-2348 | 2020-10-29 |
| 1821697376 | Sidney Patel | Physician Assistant | 1834 Oregon Pike Ste 20, Lancaster, PA 17601-6463 | 2020-10-25 |
| 1629677356 | Jason Christopher Takacs Jr. | Physician Assistant | 510 Stockton Rdg, Cranberry Township, PA 16066-2280 | 2020-10-23 |
| 1467051763 | Molly Catherine Peters | Physician Assistant | 4338 Boone St, Philadelphia, PA 19128-4901 | 2020-10-19 |
| 1508465840 | Tran Quyen Tran | Physician Assistant | 2941 Hillside Rd, Broomall, PA 19008-1304 | 2020-10-19 |
| 1275132656 | Jessica Haley Stecklein | Physician Assistant | 696 Fir Ave, Langhorne, PA 19047-5450 | 2020-10-18 |
| 1083212625 | Kele Ferreira | Physician Assistant | 1201 Sandhill Rd, Lebanon, PA 17046-1943 | 2020-10-15 |
| 1386251619 | Nicholas James Lazorka | Physician Assistant | 195 Chapmans Round Top Rd, Montoursville, PA 17754-7508 | 2020-09-30 |
| Find all providers with the same taxonomy | ||||
| City | MOON TOWNSHIP |
| Zip Code | 15108 |
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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.