NIKOLE RENAE DODGE (NPI# 1902293830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902293830 |
| Entity Type | Individual |
| Full Name | NIKOLE RENAE DODGE |
| Credential | PA-C |
| Practice Address |
379 6th Ave W Bradenton FL 34205-8820 |
| Mailing Address |
6804 Cecelia Dr New Port Richey FL 34653-4935 |
| Practice Telephone | 9417824100 |
| Practice Fax Number | 9417824101 |
| Mailing Telephone | 7272320644 |
| Mailing Fax Number | 8885460488 |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2018-06-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA9108578 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
379 6TH AVE W |
| City | BRADENTON |
| State | FL |
| Zip Code | 34205-8820 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811982531 | Thomas J Lustberg | Psychiatry & Neurology | 379 6th Ave W, Bradenton, FL 34205-8820 | 2005-09-19 |
| 1639777485 | Femina Y Patel | Counselor | 379 6th Ave W, Bradenton, FL 34205-8820 | 2020-10-14 |
| 1790314318 | Victoria Kastor | Social Worker | 379 6th Ave W, Bradenton, FL 34205-8820 | 2020-04-06 |
| 1275161341 | Andrew R Penn | Counselor | 379 6th Ave W, Bradenton, FL 34205-8820 | 2020-04-01 |
| 1881225704 | Amanda Thomas | Counselor | 379 6th Ave W, Bradenton, FL 34205-8820 | 2020-01-29 |
| 1871137216 | Kelly Sinclair Humbarger | Counselor | 379 6th Ave W, Bradenton, FL 34205-8820 | 2019-10-29 |
| 1194294181 | Betsy Elsasser | Psychologist | 379 6th Ave W, Bradenton, FL 34205-8820 | 2018-11-19 |
| 1710452511 | Elizabeth Murtaugh | Marriage & Family Therapist | 379 6th Ave W, Bradenton, FL 34205-8820 | 2018-10-08 |
| 1245735737 | Reid Warren Schwabach | Counselor | 379 6th Ave W, Bradenton, FL 34205-8820 | 2018-03-27 |
| 1679088686 | Deirdre Michelle Guilloton | Marriage & Family Therapist | 379 6th Ave W, Bradenton, FL 34205-8820 | 2017-12-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649811506 | Fenix Drug Store, LLC | Pharmacy | 527 13th St W, Bradenton, FL 34205 | 2019-10-02 |
| 1326534702 | Elaine Benitez Vazquez | Developmental Therapist | 3800 Lake Bayshore Dr Apt 513, Bradenton, FL 34205 | 2018-07-09 |
| 1437519402 | Kenneth G Bannister | Massage Therapist | 302 26th Avenue East, Apt 101, Bradenton, FL 34205 | 2016-03-03 |
| 1780028415 | Nic 4 Summerfield Leasing LLC | Assisted Living Facility | 3409 26th St. W., Bradenton, FL 34205 | 2013-04-24 |
| 1275803017 | Jennifer Geanne Washington | Massage Therapist | 1901 9th Ave W, Bradenton, FL 34205 | 2012-01-11 |
| 1629352745 | Susan K Stone | Acupuncturist | 2620 Manatee Avenue W., Suite C, Bradenton, FL 34205 | 2011-10-07 |
| 1588957609 | Palma Sola Therapies LLC | Physical Medicine & Rehabilitation | 515 36th St., Suite D, Bradenton, FL 34205 | 2011-05-23 |
| 1023254836 | Halle Kranz | Counselor | 239 301 Blvd W, Bradenton, FL 34205 | 2008-12-29 |
| 1235389537 | Aisha Mohsin Malik | Psychiatry & Neurology | 200 3rd Avenue West, Suite 110, Bradenton, FL 34205 | 2008-09-23 |
| 1689895146 | Brenda Marie Wilson | Counselor | Manatee Service Center, 600 301 Blvd - Suite 144, Bradenton, FL 34205 | 2007-05-01 |
| Find all providers in zip 34205 | ||||
| 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 |
|---|---|---|---|---|
| 1275141814 | Michi Cristina Carlsson | Physician Assistant | 231 Sun Isle Cir Unit 308, Bradenton, FL 34208-2728 | 2020-07-20 |
| 1154945178 | Dana J Scott | Physician Assistant | 9826 18th Dr Nw, Bradenton, FL 34209-8102 | 2020-06-05 |
| 1275162216 | Regina Marie Aluise | Physician Assistant | 7710 Camden Harbour Dr, Bradenton, FL 34212-9311 | 2020-04-02 |
| 1932750197 | Victor Zavala More | Physician Assistant | 200 3rd Ave W Ste 100, Bradenton, FL 34205-8628 | 2019-09-27 |
| 1083175236 | Nisha Patel | Physician Assistant | 2902 59th St W Ste C, Bradenton, FL 34209-7021 | 2019-03-29 |
| 1346735719 | Jessica Levanti | Physician Assistant | 714 Manatee Ave E Ste A, Bradenton, FL 34208-1235 | 2018-06-27 |
| 1104337294 | Desoto Lakes Emergency Physicians LLC | Physician Assistant | 8500 Sr 70 East, Bradenton, FL 34202 | 2017-10-17 |
| 1902216716 | Julie Chorley | Physician Assistant | 232 Manatee Ave E, Bradenton, FL 34208 | 2014-05-01 |
| 1841221678 | David Hervig | Physician Assistant | 9908 Sr 64 East, Bradenton, FL 34212-5303 | 2006-07-06 |
| 1861437915 | Loretta J Putvin-golding | Physician Assistant | 5309 Sr 64 E, Bradenton, FL 34208 | 2006-06-20 |
| Find all providers in BRADENTON | ||||
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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.