JILL M. REISMAN (NPI# 1881617538) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881617538 |
| Entity Type | Individual |
| Full Name | JILL M. REISMAN |
| Credential | PA |
| Practice Address |
3920 St Francis Way Ste 220 Lafayette IN 47905-4922 |
| Mailing Address |
Po Box 781076 Detroit MI 48278-1076 |
| Practice Telephone | 7655024110 |
| Practice Fax Number | 7654285951 |
| Mailing Telephone | 3175284800 |
| Mailing Fax Number | 3178651479 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2019-04-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 10000734A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 300008925 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 826 N 6th St, Monticello, IN 479601752 | 5745833333 | 5745834785 |
| Street Address |
3920 ST FRANCIS WAY STE 220 |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47905-4922 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043280670 | Salim S Abou Jaoude | Internal Medicine | 3920 St Francis Way Ste 220, Lafayette, IN 47905-4922 | 2006-01-25 |
| 1275912602 | Samuel Levi Worsham | Internal Medicine | 3920 St Francis Way Ste 220, Lafayette, IN 47905-4922 | 2015-05-18 |
| 1750677589 | Pradeep Gnanapragasam | Physical Medicine & Rehabilitation | 3920 St Francis Way Ste 220, Lafayette, IN 47905-4922 | 2011-06-20 |
| 1437200557 | Nini C Thomas | Internal Medicine | 3920 St Francis Way Ste 220, Lafayette, IN 47905 | 2007-01-16 |
| 1841387529 | Andrew J Krutul | Internal Medicine | 3920 St Francis Way Ste 220, Lafayette, IN 47905 | 2006-10-06 |
| 1477575769 | Mark D. Griffith | Physical Medicine & Rehabilitation | 3920 St Francis Way Ste 220, Lafayette, IN 47905-4922 | 2006-07-24 |
| 1205855418 | Imad E. Khadra | Internal Medicine | 3920 St Francis Way Ste 220, Lafayette, IN 47905 | 2006-07-19 |
| 1982623120 | Rita A. Mankus | Internal Medicine | 3920 St Francis Way Ste 220, Lafayette, IN 47905 | 2006-07-19 |
| 1740208180 | Shahid Ahsan | Internal Medicine | 3920 St Francis Way Ste 220, Lafayette, IN 47905-4922 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719893 | Elements Counseling LLC | Social Worker | 115 N. Farabee Drive, Lafayette, IN 47905 | 2019-09-18 |
| 1134596869 | Indiana Dental Sleep Therapy LLC | Dentist | 4921 Sr 26 E, Suite 300, Lafayette, IN 47905 | 2015-08-28 |
| 1255750899 | Emily S Miller | Physical Therapist | 1701 Creasy Ln, Lafayette, IN 47905 | 2014-04-10 |
| 1073876215 | Nathan Webster | Dentist | 1530 Kossuth St., Lafayette, IN 47905 | 2012-06-22 |
| 1578848370 | Mark Jin Kim | Pharmacist | 1801 South St., Lafayette, IN 47905 | 2011-10-13 |
| 1700177185 | Shannon Tawn Harris | Speech-Language Pathologist | 8900 Cobbler Lane, Lafayette, IN 47905 | 2011-04-20 |
| 1508164484 | David Thomas Beine | Specialist/Technologist | 1321 Unity Pl Ste A, Lafayette, IN 47905 | 2011-03-02 |
| 1447569538 | Deidre Dudley | Nurse Practitioner | 1701 S Creasy Ln Ste 1w93, Lafayette, IN 47905 | 2010-10-07 |
| 1548493067 | Unity Healthcare, LLC | Podiatrist | 750 Park East Blvd, Unit 4, Lafayette, IN 47905 | 2009-09-01 |
| 1073762969 | Lynette Marie Alexander | Nurse Practitioner | 5500 St Rd. 38 East, Lafayette, IN 47905 | 2008-09-16 |
| Find all providers in zip 47905 | ||||
| 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 |
|---|---|---|---|---|
| 1366041402 | Dillon Michael Kelly | Physician Assistant | 1214 Coolidge St., Lafayette, LA 70503-2621 | 2020-10-20 |
| 1326669334 | Rachel Fulmer Trepagnier | Physician Assistant | 111 La Rue Vil, Lafayette, LA 70508-6829 | 2020-04-30 |
| 1093299661 | Jacqueline Grainger Davidson | Physician Assistant | 2540 Westward Dr, Lafayette, CO 80026-9176 | 2018-09-19 |
| 1003394891 | Stefanie Marie Hummel | Physician Assistant | 105 Patriot St Ste 101, Lafayette, LA 70508-6831 | 2018-08-02 |
| 1477067239 | Madison Elizabeth Amos | Physician Assistant | 1140 W South Boulder Rd Ste 202, Lafayette, CO 80026-8910 | 2017-11-30 |
| 1639682164 | Callie Phillips | Physician Assistant | 3441 Golden Gate Way Apt D, Lafayette, CA 94549-4533 | 2017-11-06 |
| 1629591383 | Matthew Jacob Stephen | Physician Assistant | 12 Shreve Ln, Lafayette, CA 94549-4066 | 2017-07-24 |
| 1881114486 | Ani Akopyan | Physician Assistant | 3535 Brook St Apt 22, Lafayette, CA 94549-4336 | 2017-06-23 |
| 1851829360 | Daniel Manilla | Physician Assistant | 380 Empire Rd Ste 200, Lafayette, CO 80026-2677 | 2017-05-28 |
| 1962942839 | Marcus Ryan Davidson | Physician Assistant | 605 Silverstone Rd Ste 100, Lafayette, LA 70508 | 2017-02-27 |
| Find all providers in LAFAYETTE | ||||
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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.