MRS. DANIELLE OTIS (NPI# 1457708109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457708109 |
| Entity Type | Individual |
| Full Name | MRS. DANIELLE OTIS |
| Other Name | DANIELLE SHOULDICE |
| Credential | PA-C |
| Practice Address |
601 John St Ste M-124 Kalamazoo MI 49007-5377 |
| Mailing Address |
221 22nd St S Battle Creek MI 49015-3007 |
| Practice Telephone | 2693417500 |
| Mailing Telephone | 2695793499 |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2020-10-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
5601007780 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
601 JOHN ST STE M-124 |
| City | KALAMAZOO |
| State | MI |
| Zip Code | 49007-5377 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023326857 | Luke Britton Anderson | Counselor | 601 John St Ste M-124, Kalamazoo, MI 49007-5377 | 2010-09-14 |
| 1568092922 | Trudy Pyle | Nurse Practitioner | 601 John St Ste M-124, Kalamazoo, MI 49007-5377 | 2020-01-23 |
| 1669014130 | Courtney T Thompson | Physician Assistant | 601 John St Ste M-124, Kalamazoo, MI 49007-5377 | 2019-10-16 |
| 1598306052 | Tatiana Burkholder | Nurse Practitioner | 601 John St Ste M-124, Kalamazoo, MI 49007-5377 | 2019-10-04 |
| 1336604354 | Kaitlyn Hope Collette | Nurse Practitioner | 601 John St Ste M-124, Kalamazoo, MI 49007-5377 | 2019-02-04 |
| 1679076897 | Thomas Richard Geigert | Nurse Practitioner | 601 John St Ste M-124, Kalamazoo, MI 49007-5377 | 2018-03-14 |
| 1437663150 | Kristy Lynn Vanbeek | Psychiatry & Neurology | 601 John St Ste M-124, Kalamazoo, MI 49007-5377 | 2017-11-17 |
| 1457611956 | John Paul Bunka | Psychiatry & Neurology | 601 John St Ste M-124, Kalamazoo, MI 49007-5377 | 2012-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881248342 | Whitney Kiel | Pharmacist | 601 John Street Suite M-020, Kalamazoo, MI 49007 | 2019-08-01 |
| 1316591571 | Laura Jedele | Physical Therapist | Bronson Healthcare Group, 601 John St, Kalamazoo, MI 49007 | 2019-07-26 |
| 1992209084 | Yvonne Marie Heltzel | Behavior Technician | 1826 N Rose St, Kalamazoo, MI 49007 | 2018-03-22 |
| 1396263943 | Travis Todd Turrell | Physician Assistant | 125 S Kalamazoo Mall Suite 204, Kalamazoo, MI 49007 | 2017-09-05 |
| 1619493186 | Sarah Zuspann | Nurse Practitioner | 601 John Street, Suite 100, Kalamazoo, MI 49007 | 2017-08-16 |
| 1720529779 | Dannison | Psychologist | 604 S Rose St, Kalamazoo, MI 49007 | 2017-03-10 |
| 1265988901 | Calee Dieleman | Social Worker | 610 South Burdick, Kalamazoo, MI 49007 | 2016-09-01 |
| 1508313099 | Arriel Julia Ampey | Social Worker | 414 S. Burdick St., Suite 200, Kalamazoo, MI 49007 | 2016-09-01 |
| 1043662745 | Holloway Marston | Psychologist | 717 W South St, Apt. #6, Kalamazoo, MI 49007 | 2016-07-06 |
| 1205280062 | Bronson At Home | Home Health | 601 John St Ste M-431, Kalamazoo, MI 49007 | 2016-04-19 |
| Find all providers in zip 49007 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073057725 | Zachary Turk Harling | Physician Assistant | 2340 Waite Ave, Kalamazoo, MI 49008-1722 | 2016-12-15 |
| 1063961860 | Christine Murphy Lee | Physician Assistant | 6565 West Main St, Westside Family Medical Center, P.c, Kalamazoo, MI 49009 | 2016-09-22 |
| 1831470285 | Kalmazoo Gastroenterology Hepatology and Digestive Health Center | Physician Assistant | 1535 Gull Rd Ste 105, Kalamazoo, MI 49048-1630 | 2011-08-30 |
| 1922321322 | Lisa Marie Cotten | Physician Assistant | 4658 Silverleaf Ln, Kalamazoo, MI 49004-3179 | 2010-03-12 |
| 1043457534 | Carrie Ann Assenmacher | Physician Assistant | 1820 Shaffer Street, Kalamazoo, MI 49048-1604 | 2009-01-21 |
| 1801083126 | Jaclyn Frances Stoddard | Physician Assistant | 6565 West Main St., Kalamazoo, MI 49009 | 2007-10-01 |
| 1811085475 | James Bryon Newton | Physician Assistant | 4249 Pine Knoll Ave, Kalamazoo, MI 49004-9506 | 2006-10-10 |
| 1164490207 | William J Klerk Jr. | Physician Assistant | 1820 Shaffer St, Kalamazoo, MI 49048-1604 | 2006-03-14 |
| 1912999012 | Wayne Gerard Augustyniak | Physician Assistant | 2889 South 11th Street, Kalamazoo, MI 49009-2123 | 2005-08-16 |
| 1700880200 | Joseph Williams | Physician Assistant | 4613 W Main St, Ste. B, Kalamazoo, MI 49006-2645 | 2005-06-13 |
| Find all providers in KALAMAZOO | ||||
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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.