Jordan A Shettle (NPI# 1699030262, PAC ID# 2860648177) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL THERAPY.
| Nation Provider ID (NPI) | 1699030262 |
| PAC ID by PECOS | 2860648177 |
| Professional Enrollment ID | I20140321001322 |
| Full Name | Jordan A Shettle |
| Organization Legal Name | EVOLUTION SPORTS PHYSIOTHERAPY - WHITE MARSH LLC |
| Address |
11605 Crossroads Cir Middle River MD 21220-2865 |
| Phone Number | 4106280520 |
| Gender | M |
| Graduation Year | 2012 |
| Primary Specialty | PHYSICAL THERAPY |
| Group Practice PAC ID | 3779804307 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 11605 Crossroads Cir, Middle River, MD 21220-2865 | 4106280520 | EVOLUTION SPORTS PHYSIOTHERAPY - WHITE MARSH LLC |
| Organization Legal Name | EVOLUTION SPORTS PHYSIOTHERAPY - WHITE MARSH LLC |
| Physicians | 1 |
| Street Address |
11605 CROSSROADS CIR |
| City | MIDDLE RIVER |
| State | MD |
| Zip | 21220-2865 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Madelyn E Keese | Physical Therapy | 11605 Crossroads Cir, Middle River, MD 21220-2865 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Edwin E Pimentel-brugal | Internal Medicine | Health Md LLC | 11560 Crossroads Cir, Suite 106, Middle River, MD 21220-2885 |
| Manuel E. Perez Bonnelly | Internal Medicine | Health Md LLC | 11560 Crossroads Cir, Suite 106, Middle River, MD 21220-2885 |
| Chinwe M Okudo | Nurse Practitioner | 107 Beacon Rd, Baltimore, MD 21220-3504 | |
| Chienyenwa E Nwachinemere | Internal Medicine | 201 Ballard Ave, Middle River, MD 21220-3656 | |
| Dave A Adeleye | Nurse Practitioner | 611 Tinker Rd, Middle River, MD 21220-3773 | |
| Dontese J Nicholson | Interventional Pain Management | Lifebridge Sports Medicine and Rehabilitation LLC | 1364 Martin Blvd, Suite 5, Middle River, MD 21220-4104 |
| Kristian Kunicky | Physician Assistant | Lifebridge Sports Medicine and Rehabilitation LLC | 1364 Martin Blvd, Suite 5, Middle River, MD 21220-4104 |
| Sam W Serafi | Rheumatology | Lifebridge Sports Medicine and Rehabilitation LLC | 1364 Martin Blvd, Suite 5, Middle River, MD 21220-4104 |
| Carla A Crosby | Physical Therapy | Lifebridge Sports Medicine and Rehabilitation LLC | 1364 Martin Blvd, Suite 5, Middle River, MD 21220-4104 |
| Dina Alison Serfas | Physical Therapy | Lifebridge Sports Medicine and Rehabilitation LLC | 1364 Martin Blvd, Suite 5, Middle River, MD 21220-4104 |
| Find all physicians in zip 21220 | |||
| City | MIDDLE RIVER |
| Zip Code | 21220 |
| Specialty | PHYSICAL THERAPY |
| City + Specialty | MIDDLE RIVER + PHYSICAL THERAPY |
Please comment or provide details below to improve the information on Jordan A Shettle.
| 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.