Jessie Entwistle (NPI# 1629487665, PAC ID# 4789966052) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
| Nation Provider ID (NPI) | 1629487665 |
| PAC ID by PECOS | 4789966052 |
| Professional Enrollment ID | I20170120001959 |
| Full Name | Jessie Entwistle |
| Organization Legal Name | EPMG OF OHIO INC PA |
| Address |
1805 27th St Portsmouth OH 45662-2640 |
| Phone Number | 7403565000 |
| Gender | F |
| Medical School | KANSAS CITY UNIVERSITY OF PHYSICIANS AND SURGEONS |
| Graduation Year | 2014 |
| Primary Specialty | EMERGENCY MEDICINE |
| Group Practice PAC ID | 1052223799 |
| Number of Group Practice Members | 18 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 360008 | SOUTHERN OHIO MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1805 27th St, Portsmouth, OH 45662-2640 | 7403565000 | EPMG OF OHIO INC PA |
| 835 W Emmitt Ave, Waverly, OH 45690-1190 | 7409477662 | EPMG OF OHIO INC PA |
| Organization Legal Name | EPMG OF OHIO INC PA |
| Physicians | 14 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dalkeith F Tucker | Emergency Medicine | Epmg of Ohio Inc Pa | 1805 27th St, Portsmouth, OH 45662-2640 |
| Curtis Dee Mortensen | Emergency Medicine | Epmg of Ohio Inc Pa | 1805 27th St, Portsmouth, OH 45662-2640 |
| Derek Davis | Emergency Medicine | Epmg of Ohio Inc Pa | 1248 Kinneys Ln, Portsmouth, OH 45662-2927 |
| Matthew Mitchell Stone | Nurse Practitioner | Epmg of Ohio Inc Pa | 1805 27th St, Portsmouth, OH 45662-2640 |
| Jeanna M Hull | Physician Assistant | Epmg of Ohio Inc Pa | 835 W Emmitt Ave, Waverly, OH 45690-1190 |
| Ricardo R Romero | Family Practice | Epmg of Ohio Inc Pa | 835 W Emmitt Ave, Waverly, OH 45690-1190 |
| Lora L Stone | Nurse Practitioner | Epmg of Ohio Inc Pa | 1805 27th St, Portsmouth, OH 45662-2640 |
| Tia M King | Nurse Practitioner | Epmg of Ohio Inc Pa | 1805 27th St, Portsmouth, OH 45662-2640 |
| William J Angelos | Emergency Medicine | Epmg of Ohio Inc Pa | 1805 27th St, Portsmouth, OH 45662-2640 |
| Karissa D Couch | Nurse Practitioner | Epmg of Ohio Inc Pa | 1805 27th St, Portsmouth, OH 45662-2640 |
| Street Address |
1805 27TH ST |
| City | PORTSMOUTH |
| State | OH |
| Zip | 45662-2640 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dalkeith F Tucker | Emergency Medicine | Epmg of Ohio Inc Pa | 1805 27th St, Portsmouth, OH 45662-2640 |
| Shayna B Tomchin | Pathology | Somc Medical Care Foundation, Inc. | 1805 27th St, Portsmouth, OH 45662-2640 |
| Loretta A Settonni | Diagnostic Radiology | Somc Medical Care Foundation, Inc. | 1805 27th St, Portsmouth, OH 45662-2640 |
| Adam A Wilson | Certified Registered Nurse Anesthetist (crna) | Somc Medical Care Foundation, Inc. | 1805 27th St, Portsmouth, OH 45662-2640 |
| Jessica S Suber | Plastic and Reconstructive Surgery | Somc Medical Care Foundation, Inc. | 1805 27th St, Portsmouth, OH 45662-2640 |
| Dustin L Johnson | Diagnostic Radiology | Somc Medical Care Foundation, Inc. | 1805 27th St, Portsmouth, OH 45662-2640 |
| Michael L Purdy | Nurse Practitioner | Somc Medical Care Foundation, Inc. | 1805 27th St, Portsmouth, OH 45662-2640 |
| Adam D Evans | Interventional Radiology | Somc Medical Care Foundation, Inc. | 1805 27th St, Portsmouth, OH 45662-2640 |
| Praveena Coimbatore | Hospitalist | Apogee Medical Group Ohio Inc | 1805 27th St, Portsmouth, OH 45662-2640 |
| Jami Michelle Lyon | Diagnostic Radiology | Somc Medical Care Foundation, Inc. | 1805 27th St, Portsmouth, OH 45662-2640 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Paul S Cwikla | Podiatry | 1605 E Eleventh St, Portsmouth, OH 45662 | |
| David K Byers | Infectious Disease | Somc Medical Care Foundation, Inc. | 1729 27th St, Portsmouth, OH 45662-2638 |
| Ryan F Sandlin | Obstetrics/gynecology | Somc Medical Care Foundation, Inc. | 1729 27th St, Portsmouth, OH 45662-2638 |
| Zachary Harr | Physician Assistant | Somc Medical Care Foundation, Inc. | 1729 27th St, Portsmouth, OH 45662-2638 |
| Reena Samuel | Nephrology | Southern Ohio Nephrology, Inc. | 1711 27th St, Portsmouth, OH 45662-2638 |
| Ernesto Espe Banalagay | Nephrology | Southern Ohio Nephrology, Inc. | 1711 27th St, Portsmouth, OH 45662-2638 |
| Tiffany L Harris | Certified Nurse Midwife (cnm) | Somc Medical Care Foundation, Inc. | 1729 27th St, Portsmouth, OH 45662-2638 |
| Joseph W Herrmann | Vascular Surgery | Somc Medical Care Foundation, Inc. | 1729 27th St, Portsmouth, OH 45662-2638 |
| Phillip D Roberts | Family Medicine | Somc Medical Care Foundation, Inc. | 1729 27th St, Portsmouth, OH 45662-2638 |
| Jeffrey E Parker | General Surgery | Somc Medical Care Foundation, Inc. | 1729 27th St, Portsmouth, OH 45662-2638 |
| Find all physicians in zip 45662 | |||
| City | PORTSMOUTH |
| Zip Code | 45662 |
| Specialty | EMERGENCY MEDICINE |
| City + Specialty | PORTSMOUTH + EMERGENCY MEDICINE |
Please comment or provide details below to improve the information on Jessie Entwistle.
| 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.