JERRY A DANCIK (NPI# 1528492212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528492212 |
| Entity Type | Organization |
| Organization Name | JERRY A DANCIK |
| Other Organization Name | RENAL REDUX |
| Practice Address |
1455 S Lapeer Rd Suite 207 Lake Orion MI 48360-1467 |
| Practice Telephone | 2486909946 |
| Practice Fax Number | 2486909956 |
| Mailing Telephone | 2486909946 |
| Mailing Fax Number | 2486909956 |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2013-12-12 |
| Authorized Official Name | DR. JERRY ALLEN DANCIK (CEO) |
| Authorized Official Telephone | 2486909946 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
4301033510 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4218461 | 05 | |
| MI | 4095853 | 05 |
| Other Name | Type Code |
|---|---|
| Renal Redux | Doing Business As Name - Organization |
| Street Address |
1455 S LAPEER RD SUITE 207 |
| City | LAKE ORION |
| State | MI |
| Zip Code | 48360-1467 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386635241 | Gita K Vora | Family Medicine | 1455 S Lapeer Rd, Suite 122, Lake Orion, MI 48360-1467 | 2005-10-31 |
| 1043712896 | Renata Welker | Physical Therapist | 1455 S Lapeer Rd, Lake Orion, MI 48360-1467 | 2018-03-07 |
| 1669829057 | Gregory Jan Mcbride | Counselor | 1455 S Lapeer Rd, 175 North, Lake Orion, MI 48360-1467 | 2016-05-16 |
| 1225407943 | Oxford-orion Pllc | Clinic/Center | 1455 S Lapeer Rd, Suite 102, Lake Orion, MI 48360-1467 | 2015-09-23 |
| 1215379938 | University Physician Group | Eyewear Supplier (Equipment, not the service) | 1455 S Lapeer Rd, Suite 110, Lake Orion, MI 48360-1468 | 2013-07-23 |
| 1407081078 | Orion Oxford Urgent Care Inc | General Practice | 1455 S Lapeer Rd, Lake Orion, MI 48360-1467 | 2009-05-26 |
| 1992921621 | Praveena Sampath | Pediatrics | 1455 S Lapeer Rd, Suite 134, Lake Orion, MI 48360-1467 | 2007-04-18 |
| 1215055082 | Elite Healthcare Plc | Clinic/Center | 1455 S Lapeer Rd, Ste # 102, Lake Orion, MI 48360 | 2007-03-27 |
| 1750418059 | Jennifer Manko Prohow | Family Medicine | 1455 S Lapeer Rd, Suite 100, Lake Orion, MI 48360-1467 | 2007-02-27 |
| 1851455125 | Erik David Zuckerberg | Family Medicine | 1455 S Lapeer Rd, Suite 100, Lake Orion, MI 48360-1467 | 2006-12-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124409446 | Kyle Vires | Licensed Practical Nurse | 2271 Geyer Ct, Lake Orion, MI 48360 | 2015-06-11 |
| 1871931592 | Ihsan Asbahi | Anesthesiology | 1234 S Lapeer Rd, Lake Orion, MI 48360 | 2013-06-05 |
| 1205119567 | Michigan Bone and Joint Center | Orthopaedic Surgery | 1251 S. Lapeer Rd., Suite #102, Lake Orion, MI 48360 | 2011-09-23 |
| 1629226139 | Travis L Summerville | Physical Therapist | 1298 Walloon Way, Lake Orion, MI 48360 | 2008-09-09 |
| 1982878609 | Audrey Vizzaccaro | Physician Assistant | 1261 South Lapeer Rd, Ste 201, Lake Orion, MI 48360 | 2008-04-14 |
| 1881872265 | H & L Drugs Inc | Durable Medical Equipment & Medical Supplies | 1455 S Lapeer, Suite 101, Lake Orion, MI 48360 | 2008-02-07 |
| 1598952129 | Oakland Psychological Clinic, P.C. | Counselor | 1455 S Lapeer Rd Ste 175n, Lake Orion, MI 48360 | 2007-09-27 |
| 1700098704 | Laura Elizabeth Salome | Audiologist | 1176 S. Lapeer Rd, Lake Orion, MI 48360 | 2007-05-04 |
| 1780743658 | Frank James Iulianelli | Chiropractor | 2523 South Lapeer Road, Lake Orion, MI 48360 | 2006-12-07 |
| 1942377122 | James C Komendera Dds PC | Dentist | 1135 S Lapeer Rd, Lake Orion, MI 48360 | 2006-11-30 |
| Find all providers in zip 48360 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003440439 | Nephrocare Dialysis, LLC | Internal Medicine | Garden City Hosptial, 6245 Inkster Road, Garden City, MI 48135 | 2020-02-25 |
| 1740823459 | Critical Care Nephrology, PC | Internal Medicine | 333 E Parent Ave, Royal Oak, MI 48067-3748 | 2019-10-25 |
| 1568948537 | Amanda Thelen | Internal Medicine | 405 W Greenlawn Ave Ste 230, Lansing, MI 48910-0812 | 2018-07-12 |
| 1023507357 | James Francis Murphy | Internal Medicine | Hope Medical Clinic 518 Harriet St., Ypsilanti, MI 48197-0311 | 2018-05-02 |
| 1457865354 | Aaa Home Visiting Pllc | Internal Medicine | 1502 Fort St, Detroit, MI 48216 | 2017-11-30 |
| 1982129805 | Abhay Mishra | Internal Medicine | 4160 John R St Ste 908, Detroit, MI 48201-2017 | 2017-08-11 |
| 1326586959 | Alhaji Consultant Pllc | Internal Medicine | 29201 Chateau Ct, Farmington Hills, MI 48334-4112 | 2017-02-02 |
| 1033669445 | T-beyene Hypertension & Kidney Care Plc | Internal Medicine | 4160 John R Ste 1011, Harper Professional Building, Detroit, MI 48201 | 2016-10-10 |
| 1285085860 | Omer Yousif | Internal Medicine | 29829 Telegraph Rd Ste 202, Southfield, MI 48034-7656 | 2016-06-24 |
| 1710378377 | Rawm Vascular Access, Pllc | Internal Medicine | 1540 36th Street. Sw, Wyoming, MI 49509 | 2015-02-17 |
| Find all providers with the same taxonomy | ||||
| City | LAKE ORION |
| Zip Code | 48360 |
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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.