MICHELLE DIBAISE (NPI# 1568847267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568847267 |
| Entity Type | Individual |
| Full Name | MICHELLE DIBAISE |
| Other Name | MICHELLE SHUMWAY |
| Credential | PA-C |
| Practice Address |
230 S 12th Ave Healthcare for The Homeless Phoenix AZ 85007-3101 |
| Mailing Address |
550 N 3rd St # Street-2 Show Clinic #510 Bb Phoenix AZ 85004-2154 |
| Practice Telephone | 6028272420 |
| Practice Fax Number | 6028272425 |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2015-07-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
3633 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
230 S 12TH AVE HEALTHCARE FOR THE HOMELESS |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85007-3101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104937606 | Kris Andrew Volcheck | Dentist | 230 S 12th Ave, Phoenix, AZ 85007-3101 | 2006-08-31 |
| 1114580354 | Bobby Keyvan-jafari | Student in an Organized Health Care Education/Training Program | 230 S 12th Ave, Phoenix, AZ 85007-3101 | 2019-04-14 |
| 1124581624 | Nashid F Ahmed | Dentist | 230 S 12th Ave, Phoenix, AZ 85007-3101 | 2019-04-11 |
| 1548775497 | Circle The City | Clinic/Center | 230 S 12th Ave, Phoenix, AZ 85007-3101 | 2017-12-13 |
| 1003336215 | James Nathan Mckenna | Dentist | 230 S 12th Ave, Phoenix, AZ 85007-3101 | 2017-06-20 |
| 1801328638 | Clayton Geoffrey Wainwright Jr. | Dentist | 230 S 12th Ave, Phoenix, AZ 85007-3101 | 2017-03-30 |
| 1487014965 | Brighter Way Institute | Dentist | 230 S 12th Ave, Phoenix, AZ 85007-3101 | 2016-02-26 |
| 1154780088 | Kristine Keber | Dentist | 230 S 12th Ave, Phoenix, AZ 85007-3101 | 2016-02-20 |
| 1063871317 | Cheryll Howard | Student in an Organized Health Care Education/Training Program | 230 S 12th Ave, Phoenix, AZ 85007-3101 | 2016-02-15 |
| 1972961399 | Brian Mooney | Dentist | 230 S 12th Ave, Phoenix, AZ 85007-3101 | 2016-01-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861017824 | Tembre Eliza Delong | Student in an Organized Health Care Education/Training Program | 230 South 12th Ave, Phoenix, AZ 85007 | 2020-06-15 |
| 1841706785 | Circle The City | Clinic/Center | 206 S 12th Ave, Phoenix, AZ 85007 | 2017-12-14 |
| 1922559624 | Community Bridges, Inc. | Community/Behavioral Health | 1125 W Jackson St, Phoenix, AZ 85007 | 2016-10-18 |
| 1912358045 | Isabel Victoria Rodriguez | Speech-Language Pathologist | 2302 North 15th Avenue, Phoenix, AZ 85007 | 2016-06-30 |
| 1730441825 | Sara Joyce Edmund | Nurse Practitioner | 1424 S 7th Avenue, Phoenix, AZ 85007 | 2012-06-13 |
| 1295781771 | Ilin Chuang | Pediatrics | 150 N. 18th Ave., Suite 150, Arizona Depart. of Health Services, Phoenix, AZ 85007 | 2006-05-26 |
| 1518924802 | Michael James Higbee | Physician Assistant | 1201 S. 7th Avenue, Suite 150, Phoenix, AZ 85007 | 2006-04-28 |
| 1942278676 | David Paul Brown | Emergency Medicine | 1201 S 7 Avenue, Phoenix, AZ 85007 | 2006-03-09 |
| 1265409759 | Carol D Watkins | Emergency Medicine | 1201 S 7th Avenue, Phoenix, AZ 85007 | 2006-03-02 |
| 1982695615 | Mary Pat Nesbit | Emergency Medicine | 1201 S 7th Ave, Phoenix, AZ 85007 | 2005-11-02 |
| Find all providers in zip 85007 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073121505 | Alexandra R Koolmees | Physician Assistant | 1141 E Village Circle Dr S, Phoenix, AZ 85022-4818 | 2020-07-21 |
| 1568080620 | Manuel Gerardo Pompa | Physician Assistant | 3848 N 3rd Ave Unit 3071, Phoenix, AZ 85013-3472 | 2020-07-06 |
| 1659848208 | Pacific Dental Services Foundation | Physician Assistant | 4559 E. Bell Road, Ste 106, Phoenix, AZ 85032 | 2018-10-31 |
| 1124502372 | Amanda Rose Jones | Physician Assistant | 36427 N 14th St, Phoenix, AZ 85086-7506 | 2018-09-23 |
| 1639681745 | Martha Lopez | Physician Assistant | 7010 E Chauncey Ln Ste 210, Phoenix, AZ 85054-3115 | 2017-10-30 |
| 1386153674 | Emily Meredith Eoff | Physician Assistant | 301 W Pasadena Ave Apt 4, Phoenix, AZ 85013-2342 | 2017-09-29 |
| 1659890754 | Greg Horn | Physician Assistant | 20333 N 19th Ave Ste 230, Phoenix, AZ 85027-9901 | 2017-09-11 |
| 1619407269 | Integrative Natural Medicine | Physician Assistant | 2025 E Campbell Ave, #259, Phoenix, AZ 85016-8501 | 2017-06-15 |
| 1174996870 | Jyoti Sharma | Physician Assistant | 13838 S 46th Pl Ste 120, Phoenix, AZ 85044-7801 | 2015-11-04 |
| 1487025086 | Shaye Harrel | Physician Assistant | 9305 W Thomas Rd Ste 478, Phoenix, AZ 85037-3375 | 2015-10-08 |
| Find all providers in PHOENIX | ||||
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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.