SCOTT S MIRICK (NPI# 1780138495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780138495 |
| Entity Type | Individual |
| Full Name | SCOTT S MIRICK |
| Other Name | JOHN SCOTT SHADDY |
| Credential | PA |
| Practice Address |
1 Medical Center Dr Lebanon NH 03756-0001 |
| Practice Telephone | 6036508537 |
| Enumeration Date | 2016-08-10 |
| Last Update Date | 2019-09-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
1179 | NH | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1 MEDICAL CENTER DR |
| City | LEBANON |
| State | NH |
| Zip Code | 03756-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609473917 | Lynda Lee Lapan | Obstetrics & Gynecology | 1 Medical Center Dr, Lebanon, NH 03756-0001 | 2020-10-08 |
| 1114534708 | Dartmouth-hitchcock Clinic | Clinical Medical Laboratory | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2020-09-28 |
| 1275149858 | Makenzie Welch | Student in an Organized Health Care Education/Training Program | 1 Medical Center Dr, Lebanon, NH 03756-0001 | 2020-09-19 |
| 1598378424 | Kelcy Henrique | Pharmacist | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2020-08-29 |
| 1164034088 | Kris Douglas Halliwell | Nurse Practitioner | 1 Medical Center Dr, Lebanon, NH 03756-0001 | 2020-08-21 |
| 1275145104 | Nicole Faye Hoshiko | Dietitian, Registered | 1 Medical Center Dr, Lebanon, NH 03756-0001 | 2020-08-21 |
| 1609486703 | Melanie Lynn Del Frari | Nurse Practitioner | 1 Medical Center Dr, Lebanon, NH 03756-0001 | 2020-08-04 |
| 1346858263 | Chelsea A Jarosz | Physician Assistant | 1 Medical Center Dr, Lebanon, NH 03756-0001 | 2020-07-16 |
| 1932717170 | Sydney Allen | Registered Nurse | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2020-07-14 |
| 1033737143 | Matthew David Thomson | Registered Nurse | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2020-07-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790277796 | Sindri Aron Viktorsson | Student in an Organized Health Care Education/Training Program | Dartmouth- Hitchcock Medical Center, One Medical Center Dr, Lebanon, NH 03756 | 2018-06-05 |
| 1376078501 | Robert G.p. Murray | Student in an Organized Health Care Education/Training Program | One Medical Center Drive, Pediatric Residency Program, Children's Hospital At Dartmouth-hitchcock, Dartmouth H, Lebanon, NH 03756 | 2017-04-25 |
| 1063946242 | Keira Kilmartin | Student in an Organized Health Care Education/Training Program | One Medical Centre Drive, Pediatric Residency Program, Lebanon, NH 03756 | 2017-04-14 |
| 1194120691 | Clearchoicemd | Clinic/Center | 422 Miracle Mile Rd, Lebanon, NH 03756 | 2014-10-27 |
| 1629380159 | Rattanaporn Mahatanan | Internal Medicine | One Meical Center Drive, Dhmc Infectious Disease Department, Lebanon, NH 03756 | 2010-07-13 |
| 1780803833 | Kenneth W Travis | Anesthesiology | Darmouth Hitchock Med Ct, One Medical Ctre Drive, Lebanon, NH 03756 | 2007-04-25 |
| 1295950657 | Jillian R Ozmore | Genetic Counselor, MS | Dartmouth Hitchcock, One Medical Center Drive, Lebanon, NH 03756 | 2007-04-13 |
| 1609961119 | Athos John Rassias | Anesthesiology | Critical Care Medicine 1 Medical Center Drive, Dhmc, Lebanon, NH 03756 | 2006-10-03 |
| 1679592067 | Martha J Allen | Physician Assistant | Dartmouth Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH 03756 | 2006-07-18 |
| 1194765768 | Joseph Livin Perras II | Internal Medicine | Dartmouth-hitchcock Clinic, 1 Medical Center Dr, Lebanon, NH 03756 | 2006-06-08 |
| Find all providers in zip 03756 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558399923 | John C. Gullage | Physician Assistant | 331 Hospital Dr Ste A, Lebanon, MO 65536-9251 | 2006-06-28 |
| 1346858263 | Chelsea A Jarosz | Physician Assistant | 1 Medical Center Dr, Lebanon, NH 03756-0001 | 2020-07-16 |
| 1548885411 | Marguerite Louise Danicek | Physician Assistant | 2705 N Lebanon St Ste 210, Lebanon, IN 46052-8622 | 2020-06-16 |
| 1407497324 | Mckenna Giberson | Physician Assistant | 735 Norman Dr Ste 3, Lebanon, PA 17042-7559 | 2019-10-02 |
| 1306409818 | Kyle Lance Holsted | Physician Assistant | 1 Medical Center Drive, Department of Surgery, Lebanon, NH 03756-0001 | 2019-04-19 |
| 1124541156 | Claudia Yee Heng Lam | Physician Assistant | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2017-07-21 |
| 1922553312 | Tatyana Kalinchuk | Physician Assistant | 1 Medical Center Dr, Lebanon, NH 03756-0001 | 2016-08-16 |
| 1386015337 | Kevin W Swann | Physician Assistant | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2015-10-16 |
| 1336517630 | Jonathan Dupuis | Physician Assistant | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2015-09-03 |
| 1366827891 | Austin W Holt | Physician Assistant | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2015-07-27 |
| Find all providers in LEBANON | ||||
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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.