JOHN MERRILL (NPI# 1417004524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417004524 |
| Entity Type | Individual |
| Full Name | JOHN MERRILL |
| Practice Address |
6095 Indian River Rd Suite 201 Virginia Beach VA 23464-3818 |
| Mailing Address |
7504 Creeks End Rd Gloucester VA 23061-5006 |
| Practice Telephone | 7574207921 |
| Mailing Telephone | 8048152362 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | PA LICENSE | 0110840455 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972007516 | John Merrill | Specialist/Technologist | 2013 Glenhaven Dr, Haltom City, TX 76117-6518 | 2018-03-20 |
| 1801237276 | John Moore Merrill | Internal Medicine | 40515 County Road 69a, Suite B, Hayden, CO 81639-9504 | 2013-07-12 |
| 1548587819 | John Freeman Merrill | Denturist | 1075 Stage Rd, Etna, ME 04434 | 2010-04-27 |
| 1740357912 | John A Merrill | Dentist | 9735 Kincey Ave, Suite 206, Huntersville, NC 28078-9118 | 2006-11-30 |
| 1992152326 | John Floyd Merrill | Family Medicine | 147 N Brent St, Ventura, CA 93003-2809 | 2016-05-16 |
| 1588054480 | John Daniel Merrill | Social Worker | 276 Whitten Rd Ste 2, Hallowell, ME 04347-3035 | 2015-01-29 |
| Street Address |
6095 INDIAN RIVER RD SUITE 201 |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23464-3818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689689598 | Frederick Charles Stange | Dentist | 6095 Indian River Rd, Virginia Beach, VA 23464-3818 | 2006-07-29 |
| 1700165974 | Howard A. Mendelsohn D.d.s, PC | Dentist | 6095 Indian River Rd, Virginia Beach, VA 23464-3818 | 2011-08-05 |
| 1447569454 | Rana Tuffaha | Dentist | 6095 Indian River Rd, Virginia Beach, VA 23464-3818 | 2010-09-26 |
| 1427282094 | Vaughan Henry Howard Jr. | Family Medicine | 6095 Indian River Rd, Suite 201, Virginia Beach, VA 23464-3818 | 2009-05-11 |
| 1528202405 | Debra Ann Suslik | Pharmacist | 6095 Indian River Rd, Suite 201, Virginia Beach, VA 23464-3818 | 2009-04-23 |
| 1083747034 | Teressa A Anthony | Pharmacist | 6095 Indian River Rd, Suite 201, Virginia Beach, VA 23464-3818 | 2007-03-13 |
| 1720094725 | Dina L Pearl | Dentist | 6095 Indian River Rd, Virginia Beach, VA 23464-3818 | 2006-07-31 |
| 1154337145 | Howard A Mendelsohn | Dentist | 6095 Indian River Rd, Virginia Beach, VA 23464-3818 | 2006-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437610581 | Ainsley's Angels of America | Durable Medical Equipment & Medical Supplies | 828 Cabrini Place, Virginia Beach, VA 23464 | 2019-03-29 |
| 1104313055 | Your Family Is Family Home Healthcare Services, LLC | Respite Care | 1311 Hafford Road, Virginia Beach, VA 23464 | 2018-04-17 |
| 1497274765 | Jamie Crisman | Occupational Therapist | 1400 Fordham Drive, Virginia Beach, VA 23464 | 2017-09-18 |
| 1861919334 | Joshua Hoxter | Chiropractor | 6070 Indian River Rd Ste 102, Virginia Beach, VA 23464 | 2017-08-25 |
| 1669909917 | Toni Faye Tayag | Specialist/Technologist | 909 Tidemark Court, Virginia Beach, VA 23464 | 2017-05-17 |
| 1922545540 | Divinefavor LLC | Non-emergency Medical Transport (VAN) | 1014 Level Green Blvd, Virginia Beach, VA 23464 | 2017-01-20 |
| 1326499807 | David Klucznik | Dentist | 5564 Indian River Road, Virginia Beach, VA 23464 | 2016-06-27 |
| 1093161374 | Mawussi Komi | General Acute Care Hospital | 6271 Drew Dr, Va Beach, VA 23464 | 2016-05-05 |
| 1588071807 | Linda Mathis | Skilled Nursing Facility | 5520 Indian Road, Virginia Beach, VA 23464 | 2014-07-18 |
| 1083045561 | Manny-nelson Med LLC | Durable Medical Equipment & Medical Supplies | 1612 Centerville Turnpike, Suite 308, Virginia Beach, VA 23464 | 2013-12-09 |
| Find all providers in zip 23464 | ||||
| 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 |
|---|---|---|---|---|
| 1063047348 | Sara Minor Khadivi | Physician Assistant | 249 Cassady Ave, Virginia Beach, VA 23452-4248 | 2020-03-07 |
| 1659913283 | Jacqueline Alexander Oliver | Physician Assistant | 3198 Pacific Ave Ste 104, Virginia Beach, VA 23451-2949 | 2019-10-15 |
| 1831650266 | Amelia Jo Crutsinger | Physician Assistant | 1644 Kepler Bnd, Virginia Beach, VA 23454 | 2019-03-28 |
| 1972067908 | Taylor Elizabeth Rose | Physician Assistant | 445 Caren Dr, Virginia Beach, VA 23452-3511 | 2019-01-23 |
| 1427521533 | Stephanie Michelle Smith | Physician Assistant | 2025 Williams Farm Rd, Virginia Beach, VA 23457-1390 | 2019-01-10 |
| 1902374044 | Patricia Lynette Nash | Physician Assistant | 5589 Greenwich Rd Ste 175, Virginia Beach, VA 23462-6564 | 2018-11-07 |
| 1851884332 | Aaron Zadai | Physician Assistant | 4437 Blackwater Rd, Virginia Beach, VA 23457-1124 | 2018-06-11 |
| 1629561329 | Mary Katherine Pratt | Physician Assistant | 828 Healthy Way Ste 350, Virginia Beach, VA 23462 | 2018-06-07 |
| 1093196024 | Stephanie Zeiber | Physician Assistant | 3325 Woodsman Ln, Virginia Beach, VA 23452-5226 | 2015-06-16 |
| 1255733051 | Megan Christine Mcdevitt | Physician Assistant | 1168 First Colonial Rd Ste A, Virginia Beach, VA 23454 | 2014-09-23 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23464 |
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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.