Jacqueline S Shriver (NPI# 1083606610, PAC ID# 5698765097) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1083606610 |
| PAC ID by PECOS | 5698765097 |
| Professional Enrollment ID | I20040517001099 |
| Full Name | Jacqueline S Shriver |
| Organization Legal Name | JTDM FAMILY PRACTICE LLC |
| Address |
1067 Hager St Saint Marys OH 45885-2422 |
| Phone Number | 4193947314 |
| Gender | F |
| Credential | NP |
| Graduation Year | 1996 |
| 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 |
|---|---|
| 360032 | GRAND LAKE HEALTH SYSTEM |
| 360009 | LIMA MEMORIAL HEALTH SYSTEM |
| 360066 | ST RITA'S MEDICAL CENTER |
| 360058 | MERCER COUNTY JOINT TOWNSHIP COMMUNITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1067 Hager St, Saint Marys, OH 45885-2422 | 4193947314 | JTDM FAMILY PRACTICE LLC |
| 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 |
| Kevin M Dirksen | Nurse Practitioner | Jtdm Family Practice LLC | 801 Pro Dr, D2, Celina, OH 45822-3307 |
| 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 |
| 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 |
1067 HAGER ST |
| City | SAINT MARYS |
| State | OH |
| Zip | 45885-2422 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Marianne Ruth Etoll | Certified Nurse Midwife (cnm) | Jtdm Family Practice LLC | 1067 Hager St, Saint Marys, OH 45885-2422 |
| David J Mitchell | Obstetrics/gynecology | Jtdm Family Practice LLC | 1067 Hager St, Saint Marys, OH 45885-2422 |
| Polly F Train | Obstetrics/gynecology | Jtdm Family Practice LLC | 1067 Hager St, Saint Marys, OH 45885-2422 |
| Kelly Alexander Wilkinson | Certified Nurse Midwife | Jtdm Family Practice LLC | 1067 Hager St, Saint Marys, OH 45885-2422 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert Spees | Chiropractic | 1633 Celina Rd, Saint Marys, OH 45885-1215 | |
| Jeffrey S Chivington | Chiropractic | 575 Royal Oak Dr, Saint Marys, OH 45885-1465 | |
| Margrete Anne Irish-pearson | Nurse Practitioner | Coleman Professional Services, Inc. | 720 Armstrong St, Saint Marys, OH 45885-1800 |
| Jonathan R Tagle | Chiropractic | 153 E Spring St, St Marys, OH 45885-2311 | |
| Michael R Compton | Chiropractic | 134 W Spring St, Saint Marys, OH 45885-2312 | |
| John M Price | Optometry | 140 W Spring St, Saint Marys, OH 45885-2312 | |
| Adam Joseph Reidenbach | Certified Registered Nurse Anesthetist (crna) | Joint Township District Memorial Hospital | 200 Saint Clair Ave, Saint Marys, OH 45885-2400 |
| Paul Martin Ferreira Leonard | Emergency Medicine | Joint Township District Memorial Hospital | 200 Saint Clair Ave, Saint Marys, OH 45885-2400 |
| Amanda M Paden | Emergency Medicine | Joint Township District Memorial Hospital | 200 Saint Clair Ave, Saint Marys, OH 45885-2400 |
| Joseph Anthony Perkins | Emergency Medicine | Joint Township District Memorial Hospital | 200 Saint Clair Ave, Saint Marys, OH 45885-2400 |
| Find all physicians in zip 45885 | |||
| City | SAINT MARYS |
| Zip Code | 45885 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | SAINT MARYS + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Jacqueline S Shriver.
| 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.