JORDAN MASTALERZ (NPI# 1508417205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508417205 |
| Entity Type | Individual |
| Full Name | JORDAN MASTALERZ |
| Credential | PA-C |
| Practice Address |
120 Frank Martin Rd Ste 101 Shelbyville TN 37160-7195 |
| Mailing Address |
1580 Liberty Ln Gallatin TN 37066-9104 |
| Practice Telephone | 0986931685 |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2020-09-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 3965 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
3965 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4601 Carothers Pkwy Ste 375, Franklin, TN 370676000 | 6157914790 |
| Street Address |
120 FRANK MARTIN RD STE 101 |
| City | SHELBYVILLE |
| State | TN |
| Zip Code | 37160-7195 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255821310 | Middle Tennessee Support Services, LLC | Community Based Residential Treatment Facility, Mental Illness | 375 Uselton Road, Shelbyville, TN 37160 | 2018-05-15 |
| 1194224998 | Stephen Blake Feldhaus | Nurse Practitioner | 112 Airport Business Park Rd, Ste H, Shelbyville, TN 37160 | 2018-02-07 |
| 1285158519 | Angelique Lynn Oliver | Case Management | 604 S. Wall St., Shelbyville, TN 37160 | 2017-07-28 |
| 1215476445 | Acts of Kindness | Home Health | 213 Lane Parkway, Shelbyville, TN 37160 | 2017-02-21 |
| 1255727681 | Nancy Elizabeth Hudson | Counselor | 117 Mcgrew Street, Shelbyville, TN 37160 | 2015-04-13 |
| 1699177956 | Shelbyville Medical Group, Pllc | Family Medicine | 221 Lane Parkway, Shelbyville, TN 37160 | 2014-09-18 |
| 1154637122 | Digestive Healthcare of Central Tennessee, Pllc | Internal Medicine | 112 Airport Business Park Drive, Suite G, Shelbyville, TN 37160 | 2010-08-27 |
| 1871791293 | Frank L Jayakody Md PC | Family Medicine | 1701 North Main St, Shelbyville, TN 37160 | 2007-07-06 |
| 1871794222 | Glen Oaks, LLC | Skilled Nursing Facility | 1101 Glenoaks Rd, Shelbyville, TN 37160 | 2007-05-31 |
| 1346459385 | Chamberland Dentistry PC | Preferred Provider Organization | 1006 Colloredo Blvd, Shelbyville, TN 37160 | 2007-05-22 |
| Find all providers in zip 37160 | ||||
| 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 |
|---|---|---|---|---|
| 1548737331 | Alexandra Rose Mudd | Physician Assistant | 101 Stonecrest Rd Ste 2, Shelbyville, KY 40065-8169 | 2018-10-30 |
| 1558663534 | Laura Martin | Physician Assistant | 130 Stonecrest Rd Ste 106, Shelbyville, KY 40065-8126 | 2010-11-24 |
| 1396933271 | Catherine Elizabeth Yutmeyer | Physician Assistant | 249 N Morgan St, Shelbyville, IL 62565-1672 | 2007-10-04 |
| 1245219666 | Scott Jason Jones | Physician Assistant | 1114 N Main St Ste B, Shelbyville, TN 37160-2380 | 2006-01-13 |
| 1790267524 | Kristin Marie Hayden | Physician Assistant | 207 S Pine St, Shelbyville, IL 62565-1749 | 2018-08-29 |
| 1376020388 | Francis Leonard | Physician Assistant | 615 Washington St, Shelbyville, KY 40065-1131 | 2018-07-23 |
| 1134613425 | Danielle Elizabeth O'dell | Physician Assistant | 71 Mack Walters Rd, Shelbyville, KY 40065 | 2018-06-19 |
| 1407372568 | Kristen Vance | Physician Assistant | 1 Calsonic Way, Shelbyville, TN 37160-2031 | 2017-08-20 |
| 1144741687 | Molly Kathleen Cremons | Physician Assistant | 2451 Intelliplex Dr, Shelbyville, IN 46176-8580 | 2017-07-06 |
| 1316477078 | Grahm Smith | Physician Assistant | 1612 N Main St, Shelbyville, TN 37160-2391 | 2017-06-15 |
| Find all providers in SHELBYVILLE | ||||
| City | SHELBYVILLE |
| Zip Code | 37160 |
Please comment or provide details below to improve the information on JORDAN MASTALERZ.
| 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.