VICTORIA STARK (NPI# 1902371735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902371735 |
| Entity Type | Individual |
| Full Name | VICTORIA STARK |
| Credential | PA-C |
| Practice Address |
1498 S Sheldon Rd Plymouth MI 48170-2140 |
| Mailing Address |
15608 Flanagan St Roseville MI 48066-1481 |
| Practice Telephone | 7348904627 |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2019-08-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1498 S SHELDON RD |
| City | PLYMOUTH |
| State | MI |
| Zip Code | 48170-2140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972094027 | Plymouth Urgent Care Walk-in Clinic LLC | Clinic/Center | 1498 S Sheldon Rd, Plymouth, MI 48170 | 2018-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720611734 | Brightside Medical of Michigan, P.C. | Psychiatry & Neurology | Telemedicine Services Only / No Physical Office, Telemedicine Services Only / No Physical, MI 48170 | 2020-02-18 |
| 1265075279 | Mast Enterprises | Home Health | 40800 Five Mile Rd Ste C, Plymouth, MI 48170 | 2019-10-22 |
| 1003470964 | Smiley Private Homecare LLC | Technician, Pathology | 1098 Ann Arbor Rd #249, Plymouth, MI 48170 | 2019-04-26 |
| 1275003832 | Atsalis Dental Excellence | Dentist | 690 South Main St, Plymouth, MI 48170 | 2018-11-27 |
| 1275003808 | Danielle Cefalo | Speech-Language Pathologist | 801 W. Ann Arbor Trail Suite 220, Plymouth, MI 48170 | 2018-11-27 |
| 1962987966 | Mindful Wellness Counseling, LLC | Social Worker | 9266 Northern Ave, Plymouth, MI 48170 | 2018-09-26 |
| 1356843791 | Polaris Pharmacy Services of Michigan, LLC | Pharmacy | 9131 General Court, Plymouth, MI 48170 | 2018-03-01 |
| 1528569787 | Alcona Citizens for Health Inc | Clinic/Center | 101 S Union St Unit 101, Plymouth, MI 48170 | 2018-02-23 |
| 1073029484 | Holly Ann Haase | Technician/Technologist | 650 Church St, Plymouth, MI 48170 | 2017-12-20 |
| 1639689854 | Macomb Primary Care, P.c | Durable Medical Equipment & Medical Supplies | 851 South Main Street, Suite #3, Plymouth, MI 48170 | 2017-10-02 |
| Find all providers in zip 48170 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285184531 | Timothy Hurlburt | Physician Assistant | 30 Aldrin Rd, Plymouth, MA 02360-4804 | 2016-10-11 |
| 1336699875 | Timothy Hurlburt | Physician Assistant | 30 Aldrin Rd, Plymouth, MA 02360-4804 | 2016-10-07 |
| 1194004523 | Elizabeth Ashley Kozak | Physician Assistant | 15474 N Haggerty Rd, Plymouth, MI 48170-4893 | 2011-08-16 |
| 1821226440 | Jaime L Marani | Physician Assistant | 275 Sandwich St, Plymouth, MA 02360-2183 | 2009-06-23 |
| 1851534713 | David Brian Dickinson | Physician Assistant | 16 Hospital Rd, Plymouth, NH 03264 | 2009-04-08 |
| 1366656449 | Heather Johnson | Physician Assistant | 990 W Ann Arbor Trl, Plymouth, MI 48170-6204 | 2007-05-09 |
| 1780754978 | Kenneth Joseph Ruemenapp | Physician Assistant | 14300 N Beck Rd, Plymouth, MI 48170-3377 | 2006-11-08 |
| 1033229596 | Brittania Mcdonald | Physician Assistant | 16 Hospital Road, Plymouth Ob/gyn, Plymouth, NH 03264 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616687 | Alexandria Jaclyn Miller | Physician Assistant | 4700 Chipman Dr, Waterford, MI 48327-3413 | 2020-10-15 |
| 1639777287 | Piotr Z Purzycki | Physician Assistant | 41400 Dequindre Rd Ste 101, Sterling Heights, MI 48314-3751 | 2020-10-15 |
| 1013524859 | Amber Marie Lee | Physician Assistant | 2265 South Lindenroad, Suite A, Flint, MI 48532 | 2020-09-25 |
| 1326656844 | Dominic Farrell | Physician Assistant | 224 Portchester Rd, Holland, MI 49424-2628 | 2020-07-21 |
| 1982212072 | Alexandria Bower-nelson | Physician Assistant | 1302 Porter Drive, Charlotte, MI 48813 | 2020-07-15 |
| 1013535343 | Maria Pavia | Physician Assistant | 41302 Scarborough Ln, Novi, MI 48375-2893 | 2020-07-13 |
| 1073130241 | Kelly F Esper | Physician Assistant | 9043 Glenwood Ln, Northville, MI 48168-9129 | 2020-07-02 |
| 1811513971 | Tasha Baker | Physician Assistant | 5444 E Whitefeather Rd, Pinconning, MI 48650-8407 | 2020-06-24 |
| 1437770054 | Sterling Ryan Maxfield | Physician Assistant | 6187 Oak Grove Rd, Howell, MI 48855-8247 | 2020-05-05 |
| 1760018808 | Rachel Renee Mackmin | Physician Assistant | 41498 Mary Kay Dr, Clinton Township, MI 48038-1989 | 2020-03-20 |
| Find all providers with the same taxonomy | ||||
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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.