Amanda M Jacques (NPI# 1376082487, PAC ID# 5799062824) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1376082487 |
| PAC ID by PECOS | 5799062824 |
| Professional Enrollment ID | I20170427001647 |
| Full Name | Amanda M Jacques |
| Organization Legal Name | ASCENSION ST JOSEPH HOSPITAL |
| Address |
3210 E Huron Rd Ascension St Joseph Hospital Augres Au Gres MI 48703-9322 |
| Phone Number | 9898767104 |
| Gender | F |
| Graduation Year | 2016 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 9638070766 |
| Number of Group Practice Members | 34 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 230100 | TAWAS ST JOSEPH HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 3210 E Huron Rd, Ascension St Joseph Hospital Augres, Au Gres, MI 48703-9322 | 9898767104 | ASCENSION ST JOSEPH HOSPITAL |
| 325 E M 55 B, Ascension St Joseph Hospital Huron, Tawas City, MI 48763-8211 | 9893624626 | ASCENSION ST JOSEPH HOSPITAL |
| Organization Legal Name | ASCENSION ST JOSEPH HOSPITAL |
| Physicians | 27 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gregory A Bohn | General Surgery | Ascension St Joseph Hospital | 295 Maple St, Suite 201, Tawas City, MI 48763-9352 |
| Sarah D Woods | Nurse Practitioner | Ascension St Joseph Hospital | 325 E M 55 B, Ascension St Joseph Hospital Huron, Tawas City, MI 48763-8211 |
| Shannon M Michaud | Nurse Practitioner | Ascension St Joseph Hospital | 116 S Church St, Ascension St Joseph Hospital Hale M, Hale, MI 48739-9272 |
| Robert L Donnell | Medical Oncology | Ascension St Joseph Hospital | 110 Beech St, Tawas City, MI 48763-8314 |
| Sylvia Boloczko | Family Medicine | Ascension St Joseph Hospital | 25 E M, 55 Ascension St Joseph Hospital Women', Tawas City, MI 48763-9362 |
| Christopher R Landrey | Obstetrics/gynecology | Ascension St Joseph Hospital | 25 E M, 55 Ascension St Joseph Hospital Women', Tawas City, MI 48763-9362 |
| Joel L Pestrue | Physician Assistant | Ascension St Joseph Hospital | 25 E M, 55 Ascension St Joseph Hospital Women', Tawas City, MI 48763-9362 |
| Kenneth A Jordan | Internal Medicine | Ascension St Joseph Hospital | 25 E M, 55 Ascension St Joseph Hospital Women', Tawas City, MI 48763-9362 |
| Erica Kalbfleisch | Nurse Practitioner | Ascension St Joseph Hospital | 25 E M, 55 Ascension St Joseph Hospital Women', Tawas City, MI 48763-9362 |
| Christopher J Oravitz | Obstetrics/gynecology | Ascension St Joseph Hospital | 25 E M, 55 Ascension St Joseph Hospital Women', Tawas City, MI 48763-9362 |
| Street Address |
3210 E HURON RD ASCENSION ST JOSEPH HOSPITAL AUGRES |
| City | AU GRES |
| State | MI |
| Zip | 48703-9322 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Camille Gabriella-joanne Lutz | Physical Therapy | Renue 003 Saginaw LLC | 401 E Huron Rd, Renue Physical Therapy, Au Gres, MI 48703-9353 |
| Rebecca A Britt-dewyer | Osteopathic Manipulative Medicine | Mclaren Medical Group | 401 E Huron Rd, Au Gres, MI 48703-9356 |
| Naheed Rizvi | Internal Medicine | Mclaren Medical Group | 401 E Huron Rd, Au Gres, MI 48703-9356 |
| Shivakumar Subbarayan | Physical Therapy | 400 W Huron Rd, Augres Physical Therapy, Augres, MI 48703-9543 |
| City | AU GRES |
| Zip Code | 48703 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | AU GRES + 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.