Mitchell E Nutt (NPI# 1568461051, PAC ID# 9537225396) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OBSTETRICS/GYNECOLOGY.
| Nation Provider ID (NPI) | 1568461051 |
| PAC ID by PECOS | 9537225396 |
| Professional Enrollment ID | I20090302000703 |
| Full Name | Mitchell E Nutt |
| Organization Legal Name | JTDM FAMILY PRACTICE LLC |
| Address |
04463 State Route 66n Suite A Minster OH 45865-8727 |
| Phone Number | 4196283821 |
| Gender | M |
| Medical School | WEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1990 |
| Primary Specialty | OBSTETRICS/GYNECOLOGY |
| Group Practice PAC ID | 2163415837 |
| Number of Group Practice Members | 28 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 360032 | GRAND LAKE HEALTH SYSTEM |
| Address | Phone | Organization |
|---|---|---|
| 04463 State Route 66n, Suite A, Minster, OH 45865-8727 | 4196283821 | JTDM FAMILY PRACTICE LLC |
| 4463 State Route 66, Minster, OH 45865-8727 | 4193947314 | JTDM FAMILY PRACTICE LLC |
| 1010 Hager St, Saint Marys, OH 45885-2421 | 4193949579 | JTDM FAMILY PRACTICE LLC |
| 1040 Hager St, Saint Marys, OH 45885-2421 | 4193949959 | JTDM FAMILY PRACTICE LLC |
| 1067 Hager St, Saint Marys, OH 45885-2422 | 4193947314 | JTDM FAMILY PRACTICE LLC |
| 200 Saint Clair Ave, Saint Marys, OH 45885-2400 | 4193949512 | JTDM FAMILY PRACTICE LLC |
| 200 Saint Clair Ave, Suite 101, Saint Marys, OH 45885-2400 | 4193949522 | 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 |
| 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 |
04463 STATE ROUTE 66N SUITE A |
| City | MINSTER |
| State | OH |
| Zip | 45865-8727 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Andrea K Dietz | Optometry | John T Archer and Associates Inc | 208 N Main St, Minster, OH 45865-1121 |
| James D Luedeke | Family Medicine | Jtdm Family Practice LLC | 4463 State Route 66, Minster, OH 45865-8727 |
| Sarah A Werner | Family Medicine | Jtdm Family Practice LLC | 4463 State Route 66, Minster, OH 45865-8727 |
| Sara Lee Hess | Nurse Practitioner | Jtdm Family Practice LLC | 4463 State Route 66, Minster, OH 45865-8727 |
| Olubukola Abigail Adelola | Family Medicine | Jtdm Family Practice LLC | 4463 State Route 66, Minster, OH 45865-8727 |
| Douglas J Spieles | Chiropractic | Spieles Chiropractic Clinic Inc. | 496 N Main St, Minster, OH 45865-9537 |
| Kurt John Olding | Chiropractic | Minster Chiropractic Center LLC | 12 Eagle Dr, Suite A, Minster, OH 45865-9545 |
| Sunni L Lomnicki | Chiropractic | Minster Chiropractic Center LLC | 12 Eagle Dr, Suite A, Minster, OH 45865-9545 |
| Tyler Joseph Lomnicki | Chiropractic | Minster Chiropractic Center LLC | 12 Eagle Dr, Suite A, Minster, OH 45865-9545 |
| Maria Jane Zenz | Physical Therapy | 12 Eagle Dr, Suite A, Minster, OH 45865-9545 | |
| Find all physicians in zip 45865 | |||
| City | MINSTER |
| Zip Code | 45865 |
| Specialty | OBSTETRICS/GYNECOLOGY |
| City + Specialty | MINSTER + OBSTETRICS/GYNECOLOGY |
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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.