KIMBERLY JEAN STARK-VAN NOORD (NPI# 1497955397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497955397 |
| Entity Type | Individual |
| Full Name | KIMBERLY JEAN STARK-VAN NOORD |
| Credential | PA |
| Practice Address |
44021 Dequindre Ferndale MI 48085 |
| Mailing Address |
44021 Dequindre Attn Jan Mcfarlane Troy MI 48085 |
| Practice Telephone | 2489648787 |
| Practice Fax Number | 2489646133 |
| Mailing Telephone | 2489648787 |
| Mailing Fax Number | 2489646133 |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2009-04-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 5601004641 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | COMMERCIAL INSURANCE | 383601519 | 01 |
| MI | BLUE CROSS BLUE SHIELD OF | 0F31794 | 01 |
| Street Address |
44021 DEQUINDRE |
| City | FERNDALE |
| State | MI |
| Zip Code | 48085 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790327252 | Long Lake Rx | Pharmacy | 2888 East Long Lake Rd #120, Suite 120, Troy, MI 48085 | 2019-10-16 |
| 1538712948 | Long Lake Rx | Pharmacy | 2888 East Long Lake Rd, Suite 120, Troy, MI 48085 | 2019-07-24 |
| 1669035093 | William Beaumont Hospital | Pharmacy | Beaumont Hospital Troy, 44201 Dequindre, Room 11a0310, Troy, MI 48085 | 2019-04-22 |
| 1487126926 | Long Lake Rx | Pharmacy | 2888 E Long Lake Rd Suite 120, Troy, MI 48085 | 2018-12-21 |
| 1295226579 | Jeffrey Paul Biehl | Nurse Anesthetist, Certified Registered | 44249 Dequindre Rd., Troy, MI 48085 | 2018-05-23 |
| 1619478666 | Trisha Misiewicz | Physical Therapist | 42201 Dequindre Rd, Troy, MI 48085 | 2018-02-26 |
| 1760900393 | Sensory Rehabilitation LLC | Physical Therapist | 4413, Reilly Ct, Troy, MI 48085 | 2017-09-04 |
| 1841710837 | James L Chang | Dentist | 1883 E Wattles, Troy, MI 48085 | 2017-06-21 |
| 1033567953 | Brittany N David | Physician Assistant | 2041 E Square Lake Rd Suite 300, Troy, MI 48085 | 2016-06-01 |
| 1053784199 | Brianna Lynn Manica | Nurse Practitioner | 44201 Dequindre Rd., Ste. 400 Troy Beaumont Hospital, Troy, MI 48085 | 2015-11-12 |
| Find all providers in zip 48085 | ||||
| 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 |
|---|---|---|---|---|
| 1972102556 | Aaron Buckley | Physician Assistant | 567 Saint Louis St, Ferndale, MI 48220-2436 | 2020-10-23 |
| 1497361752 | Gina Marie Lacolla | Physician Assistant | 523 Meadowdale St, Ferndale, MI 48220-2446 | 2020-09-21 |
| 1548884588 | Zachary Michael Duquette | Physician Assistant | 2326 Garfield St, Ferndale, MI 48220-1160 | 2020-06-05 |
| 1700146495 | Karen Black | Physician Assistant | 3901 Unick Rd, Ferndale, WA 98248-9003 | 2012-05-29 |
| 1295333060 | Connor Hyde | Physician Assistant | 751 E 9 Mile Rd, Ferndale, MI 48220-1990 | 2020-10-14 |
| 1497392005 | Kristin Nicole Iannotti | Physician Assistant | 911 E 9 Mile Rd, Ferndale, MI 48220-1934 | 2019-12-02 |
| 1295132926 | Christopher Michael Gadoua | Physician Assistant | 911 E 9 Mile Rd, Ferndale, MI 48220-1934 | 2014-11-24 |
| 1265615470 | Matthew Hockman | Physician Assistant | 911 E 9 Mile Rd, Ferndale, MI 48220-1934 | 2007-12-11 |
| 1902997091 | Dennis Waxman | Physician Assistant | 111 Sullivan Ave, Ferndale, NY 12734-4315 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164022331 | Anna Lynn Shrift | Physician Assistant | 849 Black Hill Ln, Traverse City, MI 49696-8674 | 2020-10-27 |
| 1013516194 | Rebecca Mary Cronin | Physician Assistant | 4311 Kingsbrook Dr, Kalamazoo, MI 49006-3909 | 2020-10-20 |
| 1801495023 | Keriah Khairi Abd | Physician Assistant | 42836 Bloomingdale Dr, Sterling Heights, MI 48314-2843 | 2020-10-19 |
| 1154929016 | Angela Varghese | Physician Assistant | 461 Tanner Dr, Troy, MI 48085-4714 | 2020-10-13 |
| 1861090730 | Maloree Blayke Perkins | Physician Assistant | 20717 Coventry St, Clinton Twp, MI 48035-1603 | 2020-10-13 |
| 1801494000 | Sarah Puchala Lucero | Physician Assistant | 25614 Wilson Dr, Dearborn Heights, MI 48127-3427 | 2020-10-12 |
| 1871191007 | Julia Marie Tucker | Physician Assistant | 12250 E Ridge Dr, Bruce Twp, MI 48065-2011 | 2020-10-10 |
| 1164020301 | Sara Whitneyann Vandeman | Physician Assistant | 7901 S 12th St Ste 101, Portage, MI 49024-3831 | 2020-10-10 |
| 1831796267 | Jowharh Zindani | Physician Assistant | 12020 Mitchell St, Hamtramck, MI 48212-2722 | 2020-10-08 |
| 1609473198 | Rachel M. Graziano | Physician Assistant | 18 Lowell Ave Ne, Grand Rapids, MI 49503-3760 | 2020-10-07 |
| Find all providers with the same taxonomy | ||||
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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.