JACOB CAMERON SHELL (NPI# 1558889162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558889162 |
| Entity Type | Individual |
| Full Name | JACOB CAMERON SHELL |
| Practice Address |
4403 Betty Lee Blvd Gladwin MI 48624 |
| Practice Telephone | 9893298460 |
| Enumeration Date | 2017-09-03 |
| Last Update Date | 2017-09-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790135416 | Jacob Shell | Pharmacist | 733 Fashion Drive, Columbia, SC 29229 | 2016-06-14 |
| Street Address |
4403 BETTY LEE BLVD |
| City | GLADWIN |
| State | MI |
| Zip Code | 48624 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750704268 | Monica Maebel Weaver | Licensed Practical Nurse | 1426 North St. Street, Affordable Nursing Inc, Gladwin, MI 48624 | 2014-02-04 |
| 1417397407 | Richard Allen White | Registered Nurse | 655 East Cedar Avenue, Gladwin, MI 48624 | 2013-07-05 |
| 1023453040 | Amy Rebecca Brockschmidt | Counselor | Ten16 Recovery Network, 1302 Chatterton St. 2, Gladwin, MI 48624 | 2013-05-03 |
| 1447558341 | Erika Dianis | Psychologist | 655 E. Cedar Ave., Gladwin, MI 48624 | 2011-03-02 |
| 1457519456 | Bont & Medical Products Inc | Durable Medical Equipment & Medical Supplies | 895 N M18 Suite 2, Gladwin, MI 48624 | 2008-05-27 |
| 1346424454 | Regional Dialysis Services Inc | Clinic/Center | 673 Quarter Street, Gladwin, MI 48624 | 2007-12-26 |
| 1548476070 | Sambamurti . Srinivasan | Family Medicine | 602 Riverview Ct, Gladwin, MI 48624 | 2007-05-14 |
| 1295957850 | Midmichigan Visiting Nurse Association | Durable Medical Equipment & Medical Supplies | 1234 W Cedar Ave, Gladwin, MI 48624 | 2007-05-03 |
| 1710063755 | Janet Flynn | Registered Nurse | 1207 N Spring St, Gladwin, MI 48624 | 2006-10-31 |
| 1457435067 | Robert Leo Billand | Dentist | 135 S Bowery Avenue, Gladwin, MI 48624 | 2006-10-24 |
| Find all providers in zip 48624 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648940 | Danielle Johne | Student in an Organized Health Care Education/Training Program | 1623 W Sharon Rd Sw, Fife Lake, MI 49633-7214 | 2020-11-01 |
| 1285234062 | Christopher Michael Kemp | Student in an Organized Health Care Education/Training Program | 1710 Hermitage Rd, Ann Arbor, MI 48104-4503 | 2020-10-29 |
| 1326647728 | Sevcan Turk | Student in an Organized Health Care Education/Training Program | 1500 E. Medical Center Drive, Uh B2-a209, Dept. of Radiology, Neuroradiology Division, Ann Arbor, MI 48109-5030 | 2020-10-19 |
| 1013514702 | Leeza Fortner | Student in an Organized Health Care Education/Training Program | 259 Mack Ave Ste 4514, Detroit, MI 48201-2427 | 2020-10-06 |
| 1083221345 | Katelynn Ann Millard | Student in an Organized Health Care Education/Training Program | 3710 Tartan Cir, Portage, MI 49024-4094 | 2020-09-29 |
| 1952918377 | Ereny Demian | Student in an Organized Health Care Education/Training Program | 443 Phillips Ave, Clawson, MI 48017-1546 | 2020-09-29 |
| 1629685151 | Nicole Hiltner | Student in an Organized Health Care Education/Training Program | 391 Quail Ridge Ct, Waterford, MI 48327-4332 | 2020-09-29 |
| 1306453303 | Eddie D Williams | Student in an Organized Health Care Education/Training Program | 507 Pearl St, Ypsilanti, MI 48197-2076 | 2020-09-24 |
| 1538774849 | Grace Frederickson | Student in an Organized Health Care Education/Training Program | 820 Meadow Dr, Wayland, MI 49348-1369 | 2020-09-14 |
| 1215541685 | Rebecca Frey | Student in an Organized Health Care Education/Training Program | 3955 Mayfair St, Dearborn Heights, MI 48125-3039 | 2020-09-03 |
| 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.