Kevin M Dirksen (NPI# 1053891168, PAC ID# 3577815174) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1053891168 |
| PAC ID by PECOS | 3577815174 |
| Professional Enrollment ID | I20181009003616 |
| Full Name | Kevin M Dirksen |
| Organization Legal Name | JTDM FAMILY PRACTICE LLC |
| Address |
801 Pro Dr D2 Celina OH 45822-3307 |
| Phone Number | 4195866480 |
| Gender | M |
| Graduation Year | 2018 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 2163415837 |
| Number of Group Practice Members | 36 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 360058 | MERCER COUNTY JOINT TOWNSHIP COMMUNITY HOSPITAL |
| 360032 | GRAND LAKE HEALTH SYSTEM |
| Address | Phone | Organization |
|---|---|---|
| 801 Pro Dr, D2, Celina, OH 45822-3307 | 4195866480 | JTDM FAMILY PRACTICE LLC |
| 800 W Main St, Coldwater, OH 45828-1613 | 4196782341 | MERCER COUNTY JOINT TOWNSHIP COMMUNITY HOSPITAL |
| 03920 Southland Rd, New Bremen, OH 45869-9790 | 4196292772 | M E D F PHYSICIANS CORPORATION |
| Organization Legal Name | JTDM FAMILY PRACTICE LLC |
| Physicians | 35 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher John Stucke | Podiatry | Jtdm Family Practice LLC | 1013 E Spring St, Saint Marys, OH 45885-2447 |
| James D Luedeke | Family Medicine | Jtdm Family Practice LLC | 4463 State Route 66, Minster, OH 45865-8727 |
| Venkata Krishnarao Chalasani | Internal Medicine | Jtdm Family Practice LLC | 1010 Hager St, Saint Marys, OH 45885-2421 |
| James A Reichert | General Surgery | Jtdm Family Practice LLC | 830 W Main St, Suite 101, Coldwater, OH 45828-1657 |
| Mitchell E Nutt | Obstetrics/gynecology | Jtdm Family Practice LLC | 04463 State Route 66n, Suite A, Minster, OH 45865-8727 |
| Dawn P Mcnaughton | Family Medicine | Jtdm Family Practice LLC | 1040 Hager St, Saint Marys, OH 45885-2421 |
| James E Kemmler | Physical Medicine and Rehabilitation | Jtdm Family Practice LLC | 123 Hamilton St, Celina, OH 45822-1909 |
| Jacqueline S Shriver | Nurse Practitioner | Jtdm Family Practice LLC | 1067 Hager St, Saint Marys, OH 45885-2422 |
| Brooke A Lange | Physician Assistant | Jtdm Family Practice LLC | 801 Pro Dr, Celina, OH 45822-3307 |
| Sarah A Werner | Family Medicine | Jtdm Family Practice LLC | 4463 State Route 66, Minster, OH 45865-8727 |
| Street Address |
801 PRO DR D2 |
| City | CELINA |
| State | OH |
| Zip | 45822-3307 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brooke A Lange | Physician Assistant | Jtdm Family Practice LLC | 801 Pro Dr, Celina, OH 45822-3307 |
| Sarah Marie Mcdowell | Nurse Practitioner | M E D F Physicians Corporation | 801 Pro Dr, Celina, OH 45822-3307 |
| Christy L Kretzer | Nurse Practitioner | Jtdm Family Practice LLC | 801 Pro Dr, Celina, OH 45822-3307 |
| Kyle William Anderson | Physician Assistant | Joint Township District Memorial Hospital | 801 Pro Dr, Celina, OH 45822-3307 |
| Bridget Heckler | Certified Nurse Midwife (cnm) | Jtdm Family Practice LLC | 801 Pro Dr, Suite D3, Celina, OH 45822-3307 |
| Sara Lynn Gerlach | Nurse Practitioner | Jtdm Family Practice LLC | 801 Pro Dr, Suite D3, Celina, OH 45822-3307 |
| Benjamin Michael Werling | Nurse Practitioner | M E D F Physicians Corporation | 801 Pro Dr, Celina, OH 45822-3307 |
| Luis L Perez | Family Medicine | Jtdm Family Practice LLC | 801 Pro Dr, D1, Celina, OH 45822-3307 |
| Kevin John Schimmoeller | Certified Registered Nurse Anesthetist (crna) | Joint Township District Memorial Hospital | 801 Pro Dr, Celina, OH 45822-3307 |
| Jodi K Tebbe | Certified Clinical Nurse Specialist (cns) | M E D F Physicians Corporation | 801 Pro Dr, Celina, OH 45822-3307 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shanthi Satyanarayana | Internal Medicine | 950 S Main, Suite 2, Celina, OH 45822 | |
| Gina Van Arsdel | Chiropractic | 125 E Forest St, Celina, OH 45822-1212 | |
| Aaron Pruitt | Chiropractic | Celina Chiropractic Care Inc | 125 E Forest St, Celina, OH 45822-1212 |
| Brian T Gerlach | Optometry | Grand Lake Eyecare LLC | 1025 Grand Lake Rd, Celina, OH 45822-1309 |
| Christie Grieshop | Optometry | Grand Lake Eyecare LLC | 1025 Grand Lake Rd, Celina, OH 45822-1309 |
| Lindsay M Dues | Optometry | Grand Lake Eyecare LLC | 1025 Grand Lake Rd, Celina, OH 45822-1309 |
| James T Schmit | Chiropractic | 806 E Wayne St, Celina, OH 45822-1359 | |
| Joshua J Werling | Optometry | Mercer In-sight LLC | 706 E Wayne St, Celina, OH 45822-1380 |
| Franklin D Tangeman | Optometry | Mercer In-sight LLC | 706 E Wayne St, Celina, OH 45822-1380 |
| Tiffany A Burden | Clinical Social Worker | Momentum Counseling and Consultation, LLC | 112 /2 N Main St, Celina, OH 45822-1729 |
| Find all physicians in zip 45822 | |||
| City | CELINA |
| Zip Code | 45822 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | CELINA + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Kevin M Dirksen.
| 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.