MELISSA DUTRA (NPI# 1972001428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972001428 |
| Entity Type | Individual |
| Full Name | MELISSA DUTRA |
| Credential | PA-C |
| Practice Address |
210 N Breiel Blvd Middletown OH 45042-3808 |
| Practice Telephone | 5134247231 |
| Practice Fax Number | 5134241770 |
| Mailing Telephone | 5134247231 |
| Mailing Fax Number | 5134241770 |
| Enumeration Date | 2018-01-30 |
| Last Update Date | 2019-05-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 50.005923RX | OH | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 9111077 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
210 N BREIEL BLVD |
| City | MIDDLETOWN |
| State | OH |
| Zip Code | 45042-3808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932192515 | Jennifer M Ridge | Specialist | 210 N Breiel Blvd, Middletown, OH 45042-3808 | 2005-08-29 |
| 1447307194 | Jennifer M Ridge Md Inc | Specialist | 210 N Breiel Blvd, Middletown, OH 45042-3808 | 2007-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801413919 | Stacey Ward | Nurse Practitioner | 1055 Summit Dr., Middletown, OH 45042 | 2020-07-06 |
| 1962978759 | Stephani Chandra Miller | Counselor | 160 N. Breiel Blvd, Middletown, OH 45042 | 2018-10-18 |
| 1124504378 | Butler County Community Health Consortium, Inc. | Clinic/Center | 601 N Breiel Blvd Ste B, Middletown, OH 45042 | 2018-07-11 |
| 1417474883 | Tiffany Marie Ott | Registered Nurse | 1229 Ellen Dr, Middletown, OH 45042 | 2017-08-27 |
| 1184074650 | Camelot Realty, LLC | Intermediate Care Facility, Mentally Retarded | 1909 Jackson Lane, Middletown, OH 45042 | 2016-06-15 |
| 1639529100 | Camelot Realty, LLC | Intermediate Care Facility, Mentally Retarded | 4623 Central Avenue, Middletown, OH 45042 | 2016-06-15 |
| 1811347388 | Camelot Raalty, LLC | Intermediate Care Facility, Mentally Retarded | 4923 Hendrickson Rd, Middletown, OH 45042 | 2016-06-15 |
| 1790135234 | Camelot Realty, LLC | Intermediate Care Facility, Mentally Retarded | 4895 Hendrickson Rd., Middletown, OH 45042 | 2016-06-15 |
| 1720438294 | Camelot Realty, LLC | Intermediate Care Facility, Mentally Retarded | 4907 Hendrickson Rd., Middletown, OH 45042 | 2016-06-15 |
| 1174948129 | Sherry L. Flannery | Nurse Practitioner | 4961 Middletown Oxford Road, Middletown, OH 45042 | 2014-02-27 |
| Find all providers in zip 45042 | ||||
| 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 |
|---|---|---|---|---|
| 1235738006 | Amanda Kwartemaah Osei | Physician Assistant | 2 Colonial Sq, Middletown, NJ 07748-3548 | 2020-10-22 |
| 1740777234 | Susan Ko-velez | Physician Assistant | 941 Rte 35, Middletown, NJ 07748-2601 | 2018-04-19 |
| 1265880918 | Jared Marshall | Physician Assistant | 222 Carriage Crossing Ln, Middletown, CT 06457-5862 | 2016-06-02 |
| 1184921322 | Juliane Natasha Everest | Physician Assistant | 1680 Route 35, Family Wellness Center, Middletown, NJ 07748 | 2011-02-24 |
| 1326271412 | Kristin Myers | Physician Assistant | 896 Washington St, Middletown, CT 06457-2912 | 2009-08-24 |
| 1245410422 | Kristine Carta Lane | Physician Assistant | 540 Saybrook Rd Ste 110, Middletown, CT 06457-4711 | 2007-11-06 |
| 1003001587 | Mary Chau Tran | Physician Assistant | 400 Saybrook Rd Ste 205, Middletown, CT 06457-4775 | 2007-09-07 |
| 1417153131 | Kimberly Marie Dembeck | Physician Assistant | 75 Crystal Run Rd Ste G40, Middletown, NY 10941-7000 | 2007-06-21 |
| 1659460236 | Irene Eng | Physician Assistant | 25 Myrtle Ave, Middletown, NY 10940-4122 | 2006-10-12 |
| 1821001298 | Byron Edward Schieber | Physician Assistant | 81 Constellation Ct, Middletown, PA 17057-5086 | 2006-08-15 |
| Find all providers in MIDDLETOWN | ||||
| City | MIDDLETOWN |
| Zip Code | 45042 |
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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.