JAKE ANTHONY NICHOLSON (NPI# 1467013698) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467013698 |
| Entity Type | Individual |
| Full Name | JAKE ANTHONY NICHOLSON |
| Credential | DO |
| Practice Address |
100 Michigan St Ne Ste A501 Grand Rapids MI 49503-2560 |
| Practice Telephone | 6163910056 |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2019-07-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
5151014043 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
100 MICHIGAN ST NE STE A501 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49503-2560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467748210 | John Dillon Galbraith | Surgery | 100 Michigan St Ne Ste A501, Grand Rapids, MI 49503 | 2011-06-21 |
| 1225650401 | Mohammed Khalil Al Tarhuni | Student in an Organized Health Care Education/Training Program | 100 Michigan St Ne Ste A501, Grand Rapids, MI 49503-2560 | 2020-05-11 |
| 1467074930 | Jason Kessler | Student in an Organized Health Care Education/Training Program | 100 Michigan St Ne Ste A501, Grand Rapids, MI 49503-2560 | 2020-05-07 |
| 1912527300 | Emily Meta Pardington | Student in an Organized Health Care Education/Training Program | 100 Michigan St Ne Ste A501, Grand Rapids, MI 49503-2560 | 2020-04-26 |
| 1417577933 | Kyle Sproull | Student in an Organized Health Care Education/Training Program | 100 Michigan St Ne Ste A501, Grand Rapids, MI 49503-2560 | 2020-04-24 |
| 1316576689 | Matthew Webb | Student in an Organized Health Care Education/Training Program | 100 Michigan St Ne Ste A501, Grand Rapids, MI 49503-2560 | 2020-04-07 |
| 1447889837 | Sophia Garfinkel | Student in an Organized Health Care Education/Training Program | 100 Michigan St Ne Ste A501, Grand Rapids, MI 49503-2560 | 2020-04-07 |
| 1669001491 | Sindhu Vasini Mannava | Student in an Organized Health Care Education/Training Program | 100 Michigan St Ne Ste A501, Grand Rapids, MI 49503-2560 | 2020-04-03 |
| 1487283354 | Matthew Francis Roth | Student in an Organized Health Care Education/Training Program | 100 Michigan St Ne Ste A501, Grand Rapids, MI 49503-2560 | 2020-04-03 |
| 1295364388 | Jesse Keith Kelley | Student in an Organized Health Care Education/Training Program | 100 Michigan St Ne Ste A501, Grand Rapids, MI 49503-2560 | 2020-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496195 | Airway Oxygen, Inc. | Durable Medical Equipment & Medical Supplies | Lemmen Holton Cancer Pavilion, 145 Michigan St Ne Ste 3400, Grand Rapids, MI 49503 | 2020-10-27 |
| 1730707282 | Adriana Molina-schmuker | Counselor | 901 Eastern Avenue Ne, Grand Rapids, MI 49503 | 2020-07-10 |
| 1477176949 | Kimberly Buskirk | Specialist | 1131 Ionia Ava Nw, Grand Rapids, MI 49503 | 2020-05-19 |
| 1124647805 | Jared Host | Speech-Language Pathologist | Mercy Health Hauenstein Neuroscience Center 220 Cherry, Grand Rapids, MI 49503 | 2020-04-13 |
| 1265061378 | Heather Gladfelter | Student in an Organized Health Care Education/Training Program | 339 Barclay Ave Ne Ste 300, Grand Rapids, MI 49503 | 2020-04-02 |
| 1194368647 | Amy Jo Arends | Nurse Practitioner | 350 Lafayette S.e., Suite 301, Grand Rapids, MI 49503 | 2019-10-28 |
| 1376185199 | Beth Arce | Occupational Therapist | 245 Cherry St Se Suite 302, Grand Rapids, MI 49503 | 2019-10-14 |
| 1295387256 | Althea Ziolkowski | Licensed Practical Nurse | Salvation Army Turning Point Programs, 1215 Fulton St E, Grand Rapids, MI 49503 | 2019-07-10 |
| 1790340719 | Heather Anne Fox | Occupational Therapist | Marywood, 111 Lakeside Dr Ne, Grand Rapids, MI 49503 | 2019-05-06 |
| 1184182883 | April L Kaiserlian | Social Worker | 983 Spaulding Ave Ne, Ada, MI 49503 | 2019-03-12 |
| Find all providers in zip 49503 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558326009 | Lee A Rea | Surgery | 4047 Saladin Dr Se, Grand Rapids, MI 49546-6249 | 2006-04-19 |
| 1265927438 | Ivan Noffsker | Surgery | 221 Michigan St Ne Ste 402, Grand Rapids, MI 49503-2538 | 2018-06-28 |
| 1427578004 | Kush Sharma | Surgery | 221 Michigan St Ne Ste 402, Grand Rapids, MI 49503-2538 | 2017-06-23 |
| 1154772515 | Joyce Lu | Surgery | 221 Michigan St Ne, Suite 200a, Grand Rapids, MI 49503-2543 | 2016-06-28 |
| 1790025898 | George Torao Sugiyama | Surgery | 4069 Lake Dr Se, Suite 312, Grand Rapids, MI 49546-8816 | 2013-02-26 |
| 1194088120 | Lindsey Marie Korepta | Surgery | 221 Michigan St Ne, Suite 200a, Grand Rapids, MI 49503-2543 | 2012-06-25 |
| 1578859542 | Michelle Kosovec | Surgery | 310 Lafayette Ave Se, Suite 301, Grand Rapids, MI 49503-4693 | 2011-06-28 |
| 1700052230 | Michigan Medical PC | Surgery | 2093 Health Dr Sw, Grand Rapids, MI 49519-9691 | 2008-05-05 |
| 1306018528 | Michigan Medical Patient Care | Surgery | 4085 Burton St Se, Grand Rapids, MI 49546-2444 | 2008-03-27 |
| 1396954376 | Eanas S Yassa | Surgery | 4069 Lake Dr Se, Suite 312, Grand Rapids, MI 49546-8816 | 2007-05-22 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49503 |
Please comment or provide details below to improve the information on JAKE ANTHONY NICHOLSON.
| 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.