ANGELA GALE GROVERMAN (NPI# 1720084585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720084585 |
| Entity Type | Individual |
| Full Name | ANGELA GALE GROVERMAN |
| Other Name | ANGELA GALE FOSTER |
| Credential | PA-C |
| Practice Address |
12140 New York Ranch Rd Jackson CA 95642-9407 |
| Mailing Address |
Po Box 939 Angels Camp CA 95222-0939 |
| Practice Telephone | 2092572400 |
| Practice Fax Number | 2092572403 |
| Mailing Telephone | 2097546262 |
| Mailing Fax Number | 8662058079 |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2008-05-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA15037 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
12140 NEW YORK RANCH RD |
| City | JACKSON |
| State | CA |
| Zip Code | 95642-9407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093165953 | Kevin Sidhu | Family Medicine | 12140 New York Ranch Rd, Jackson, CA 95642-9407 | 2016-06-21 |
| 1306245774 | Geralyn Da Silva | Dietitian, Registered | 12140 New York Ranch Rd, Jackson, CA 95642-9407 | 2014-08-21 |
| 1982957098 | Tamara Stogner | Registered Nurse | 12140 New York Ranch Rd, Jackson, CA 95642-9407 | 2012-10-26 |
| 1730304676 | Susan E Suares | Nurse Practitioner | 12140 New York Ranch Rd, Jackson, CA 95642-9407 | 2007-04-16 |
| 1902965122 | Lynda B Lazar | Nurse Practitioner | 12140 New York Ranch Rd, Jackson, CA 95642-9407 | 2006-12-06 |
| 1477553261 | Alisa A Roda | Pediatrics | 12140 New York Ranch Rd, Jackson Rancheria Health Complex, Jackson, CA 95642-9407 | 2005-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932666575 | Gold Country Health Initiative, LLC | Family Medicine | 820/830 State Highway 88, Jackson, CA 95642 | 2019-03-01 |
| 1053844902 | Kathryn Erosa | Pharmacist | 515 Highway 49 South, Jackson, CA 95642 | 2017-04-07 |
| 1356882039 | Thomas Alan Bowhay | Clinic/Center | 820 Highway 88, Jackson, CA 95642 | 2017-03-15 |
| 1710130141 | Roland E Womack | Dentist | 511 Sutter St, Jackson, CA 95642 | 2008-10-29 |
| 1508929522 | Stanley M Ordonez | Dentist | 645 New York Ranch Rd, Jackson, CA 95642 | 2006-12-19 |
| 1942374996 | Thomas W Zeiler | Chiropractor | 665 New York Ranch Rd Suite 2, Jackson, CA 95642 | 2006-11-20 |
| 1023188968 | Cordelia Rose Slayter | Physical Therapist | 711 S State Hwy 49, Jackson, CA 95642 | 2006-11-08 |
| 1285744946 | Raleys | Pharmacy | 781 South Highway 49, Jackson, CA 95642 | 2006-08-30 |
| 1316996747 | Robert R. Bussell X | Physical Therapist | 813 Court Street, Ste 2, Jackon, CA 95642 | 2006-05-10 |
| 1861953135 | Chelsea Yule Solutions | Clinic/Center | 230 N Main St, Jackson, CA 95642 | 2019-03-28 |
| Find all providers in zip 95642 | ||||
| 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 |
|---|---|---|---|---|
| 1942834494 | Emily Amburn | Physician Assistant | 2968 N Highland Ave, Jackson, TN 38305-3409 | 2020-02-24 |
| 1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
| 1972161891 | Allison Taylor | Physician Assistant | 1850 Chadwick Drive, Suite 1427, North Tower, 4 West, Jackson, MS 39204-3404 | 2019-06-05 |
| 1306302328 | Chloe A Goldfarb | Physician Assistant | 21 Shoal Rd, Jackson, NJ 08527-4025 | 2019-02-14 |
| 1447722558 | Casey James Elliott | Physician Assistant | 747 Oakwood St, Jackson, MS 39202-1121 | 2018-12-31 |
| 1700372109 | Chad Zawacki | Physician Assistant | 147 North Star Drive, Jackson, TN 38305 | 2018-07-09 |
| 1982194551 | Samantha Lynn Denoville | Physician Assistant | 1 Kensington Ct, Jackson, NJ 08527-1292 | 2018-05-18 |
| 1104320308 | Dalton Glenn Weaver | Physician Assistant | 708 N Highland Ave, Jackson, TN 38301-4829 | 2018-03-21 |
| 1336669258 | Whitney J Peterson | Physician Assistant | 501 Marshall St Ste 301, Jackson, MS 39202-1687 | 2017-06-21 |
| 1922541093 | Jacob Carpenter | Physician Assistant | 2497 N West St, Jackson, MS 39216-4409 | 2016-11-22 |
| Find all providers in JACKSON | ||||
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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.