Jennifer L Datta (NPI# 1083676969, PAC ID# 1254315971) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1083676969 |
| PAC ID by PECOS | 1254315971 |
| Professional Enrollment ID | I20110119000713 |
| Full Name | Jennifer L Datta |
| Organization Legal Name | SOUTHWESTERN RECOVERY CENTER, LLC |
| Address |
4461 Broadway Suite 150 Grove City OH 43123-3064 |
| Phone Number | 6145942141 |
| Gender | F |
| Credential | NP |
| Graduation Year | 1999 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 5294095956 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | M |
| Address | Phone | Organization |
|---|---|---|
| 4461 Broadway, Suite 150, Grove City, OH 43123-3064 | 6145942141 | SOUTHWESTERN RECOVERY CENTER, LLC |
| 380 Cline Ave, Suite 1, Mansfield, OH 44907-1056 | 7402125900 | SAFERX SOLUTIONS |
| 1065 Delaware Ave, Suite A, Marion, OH 43302-6461 | 6145684646 | SAFERX SOLUTIONS |
| Organization Legal Name | SOUTHWESTERN RECOVERY CENTER, LLC |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Letisha E Leach | Nurse Practitioner | Southwestern Recovery Center, LLC | 4461 Broadway, Suite 150, Grove City, OH 43123-3064 |
| Rachael Nicole Haines | Physician Assistant | Southwestern Recovery Center, LLC | 4461 Broadway, Suite 150, Grove City, OH 43123-3064 |
| David P Keseg | Emergency Medicine | Southwestern Recovery Center, LLC | 4461 Broadway, Suite 150, Grove City, OH 43123-3064 |
| Richard Harris | Emergency Medicine | Southwestern Recovery Center, LLC | 4461 Broadway, Suite 150, Grove City, OH 43123-3064 |
| Jaime Allison Snyder | Nurse Practitioner | Southwestern Recovery Center, LLC | 4461 Broadway, Suite 150, Grove City, OH 43123-3064 |
| Street Address |
4461 BROADWAY SUITE 150 |
| City | GROVE CITY |
| State | OH |
| Zip | 43123-3064 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Letisha E Leach | Nurse Practitioner | Southwestern Recovery Center, LLC | 4461 Broadway, Suite 150, Grove City, OH 43123-3064 |
| Rachael Nicole Haines | Physician Assistant | Southwestern Recovery Center, LLC | 4461 Broadway, Suite 150, Grove City, OH 43123-3064 |
| David P Keseg | Emergency Medicine | Southwestern Recovery Center, LLC | 4461 Broadway, Suite 150, Grove City, OH 43123-3064 |
| Richard Harris | Emergency Medicine | Southwestern Recovery Center, LLC | 4461 Broadway, Suite 150, Grove City, OH 43123-3064 |
| Jaime Allison Snyder | Nurse Practitioner | Southwestern Recovery Center, LLC | 4461 Broadway, Suite 150, Grove City, OH 43123-3064 |
| Angel L Villanueva Jr. | Emergency Medicine | 4461 Broadway, Suite 150, Grove City, OH 43123-3064 | |
| Genevieve B Hagerty | Obstetrics/gynecology | 4461 Broadway, Suite 200, Grove City, OH 43123-3064 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Samantha Welcher | Physical Therapy | Ohrh, LLC | 3148 Broadway, Suite 302, Grove City, OH 43123-1781 |
| Christopher Love | Chiropractic | 3590 Hoover Rd, Grove City, OH 43123-1807 | |
| Leslie A Rapsawich | Chiropractic | Wieging Physical Medicine LLC | 3435 Farm Bank Way, Grove City, OH 43123-1974 |
| Ryan Ohl | Chiropractic | Wieging Physical Medicine LLC | 3435 Farm Bank Way, Grove City, OH 43123-1974 |
| Carrie A Jones | Physician Assistant | Wieging Physical Medicine LLC | 3435 Farm Bank Way, Grove City, OH 43123-1974 |
| Thomas Schindler | Physical Therapy | Wieging Physical Medicine LLC | 3435 Farm Bank Way, Grove City, OH 43123-1974 |
| Jeffery D Wieging | Chiropractic | Wieging Physical Medicine LLC | 3435 Farm Bank Way, Grove City, OH 43123-1974 |
| Elizabeth A Myer | Nurse Practitioner | Mount Carmel Healthproviders Inc | 3636 Broadway, Grove City, OH 43123-2202 |
| Vijay Jain | Family Practice | Mount Carmel Healthproviders Inc | 3636 Broadway, Grove City, OH 43123-2202 |
| Brenda S Calhoun | Nurse Practitioner | Mount Carmel Healthproviders Inc | 3636 Broadway, Grove City, OH 43123-2202 |
| Find all physicians in zip 43123 | |||
| City | GROVE CITY |
| Zip Code | 43123 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | GROVE CITY + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.