DR. KYLE GUSTAFSON (NPI# 1992326300) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992326300 |
| Entity Type | Individual |
| Full Name | DR. KYLE GUSTAFSON |
| Credential | PHARMD |
| Practice Address |
18697 Bagley Rd Middleburg Heights OH 44130-3497 |
| Mailing Address |
8784 Pointe Dr Broadview Heights OH 44147-3510 |
| Practice Telephone | 4408164496 |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2020-04-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
03229742 | OH | Pharmacy Service Providers |
| Y | 1835C0205X |
Pharmacist Specialization: Critical Care |
03229742 | OH | Pharmacy Service Providers |
| Street Address |
18697 BAGLEY RD |
| City | MIDDLEBURG HEIGHTS |
| State | OH |
| Zip Code | 44130-3497 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316568124 | Laura Stasiak | Pharmacist | 18697 Bagley Rd, Middleburg Heights, OH 44130-3417 | 2020-05-04 |
| 1295365088 | Hannah Blackburn | Physical Therapist | 18697 Bagley Rd, Middleburg Heights, OH 44130-3417 | 2020-01-21 |
| 1861038077 | Rebecca Ann Pollack | Emergency Medicine | 18697 Bagley Rd, Middleburg Heights, OH 44130-3497 | 2019-11-22 |
| 1609422138 | Kali Potopsky | Physician Assistant | 18697 Bagley Rd, Middleburg Heights, OH 44130-3417 | 2019-08-12 |
| 1699335588 | James Miner | Anesthesiologist Assistant | 18697 Bagley Rd, Middleburg Heights, OH 44130-3417 | 2019-06-13 |
| 1871054080 | Mary Gulla | Physical Therapist | 18697 Bagley Rd, Middleburg Heights, OH 44130-3417 | 2019-03-29 |
| 1629537253 | David Brian Haberman | Physical Therapist | 18697 Bagley Rd, Middleburg Heights, OH 44130-3417 | 2019-03-13 |
| 1649737487 | Amanda Vitek | Nurse Practitioner | 18697 Bagley Rd, Middleburg Heights, OH 44130-3417 | 2019-02-28 |
| 1356815922 | Hni Medical Services of Ohio, LLC | Internal Medicine | 18697 Bagley Rd, Middleburg Heights, OH 44130-3417 | 2019-01-17 |
| 1083199947 | Oleg Golota | Nurse Anesthetist, Certified Registered | 18697 Bagley Rd, Middleburg Heights, OH 44130-3417 | 2018-09-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912545427 | Northeast Care Center, Inc. | Intermediate Care Facility, Mentally Retarded | 19080 Bagley Road, Middleburg Hts., OH 44130 | 2019-12-16 |
| 1982189148 | Carl Steinhoff | Registered Nurse | 13766 Cherokee Trail, Middleburg Heights, OH 44130 | 2018-10-03 |
| 1649756321 | Beatrice Shepherd | Counselor | 5253 Hauserman Rd Apt 212, Parma, OH 44130 | 2018-07-16 |
| 1841705068 | New Heights Aba, LLC | Behavioral Analyst | 6908 Engle Rd Ste D, Middleburg Heights, OH 44130 | 2017-12-11 |
| 1275059842 | Tynisha Nicole Nation | Registered Nurse | 6431 Olde York, Parma Hts, OH 44130 | 2017-08-16 |
| 1609328558 | Lisa Wolanin | Physical Therapist | 186970bagley Road, Middleburg Hts, OH 44130 | 2016-10-26 |
| 1184074205 | Tanya Makowski | Nurse Practitioner | 7215 Old Oak Blvd Ste A420, Cleveland, OH 44130 | 2016-06-20 |
| 1093165706 | Dana Hyde | Dentist | 7528 Pearl Rd, Middleburg Heights, OH 44130 | 2016-06-14 |
| 1689046625 | Kimberly Ann Piro | Nurse Practitioner | 12240 Zona Ln, Parma, OH 44130 | 2015-10-29 |
| 1225400088 | Larrise Williford | Registered Nurse | 11491 Sharon Dr Apt C705, Parma, OH 44130 | 2015-10-20 |
| Find all providers in zip 44130 | ||||
| Taxonomy Code | 1835C0205X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Critical Care |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in the delivery of patient care services by pharmacists, as integral members of interprofessional teams, working to ensure the safe and effective use of medications in critically ill patients. |
| Notes: Source: Board of Pharmacy Specialties, www.bpsweb.org [1/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447869433 | David Mark Peters Jr. | Pharmacist | 1 Wyoming St, Dayton, OH 45409-2722 | 2020-07-27 |
| 1851927032 | Suzanne Van Fleet | Pharmacist | 7700 University Dr, West Chester, OH 45069-2505 | 2020-03-19 |
| 1912557422 | Nathanael Smith | Pharmacist | 405 W Grand Ave, Dayton, OH 45405-7538 | 2019-09-17 |
| 1851946768 | Nick Wolters | Pharmacist | 405 W Grand Ave, Dayton, OH 45405-7538 | 2019-08-07 |
| 1508327511 | Alia Anne Poore | Pharmacist | 18101 Lorain Ave, Cleveland, OH 44111-5612 | 2019-03-31 |
| 1629558747 | Joshua Arnold | Pharmacist | 410 W 10th Ave, Columbus, OH 43210-1240 | 2018-08-17 |
| 1447745856 | Jaimini Sandip Patel | Pharmacist | 1 Akron General Ave, Akron, OH 44307-2432 | 2018-06-27 |
| 1780195222 | Logan Olson | Pharmacist | 410 W 10th Ave, Columbus, OH 43210-1240 | 2017-10-23 |
| 1558871129 | Brittany Rae Kiracofe | Pharmacist | 410 W 10th Ave, Columbus, OH 43210-1240 | 2017-10-09 |
| 1821543364 | Molly Jean Thompson | Pharmacist | 410 W 10th Ave, Columbus, OH 43210-1240 | 2016-08-24 |
| Find all providers with the same taxonomy | ||||
| City | MIDDLEBURG HEIGHTS |
| Zip Code | 44130 |
Please comment or provide details below to improve the information on DR. KYLE GUSTAFSON.
| 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.