KELLY BACKERS (NPI# 1205204385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205204385 |
| Entity Type | Individual |
| Full Name | KELLY BACKERS |
| Practice Address |
1012 W Huron St Waterford MI 48328-3730 |
| Practice Telephone | 2486811880 |
| Mailing Telephone | 2486811880 |
| Enumeration Date | 2015-09-08 |
| Last Update Date | 2017-03-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 5601007474 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1012 W HURON ST |
| City | WATERFORD |
| State | MI |
| Zip Code | 48328-3730 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982692273 | Andrew Zazaian | Internal Medicine | 1012 W Huron St, Waterford, MI 48328-3730 | 2005-10-11 |
| 1912541681 | Robert Oshnock | Physician Assistant | 1012 W Huron St, Waterford, MI 48328-3730 | 2019-11-05 |
| 1902818230 | Michigan Internal Medicine Associates,p.c. | Physician Assistant | 1012 W Huron St, Waterford, MI 48328-3730 | 2006-08-13 |
| 1871581934 | John S Zazaian | Internal Medicine | 1012 W Huron St, Waterford, MI 48328-3730 | 2005-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477184125 | Lillian Atty | Pharmacist | 1484 Rivona Dr, Waterford, MI 48328 | 2020-01-31 |
| 1437631850 | Rana Ismail | Pharmacist | 3273 West Huron St, Waterford, MI 48328 | 2018-09-01 |
| 1588181978 | India Dunlap | Social Worker | 279 Summit Dr., Waterford, MI 48328 | 2017-08-25 |
| 1689191280 | Sydney Strandberg | Social Worker | 1145 Parkway, Waterford, MI 48328 | 2017-08-24 |
| 1467982074 | Briana Greenlee | Dietitian, Registered | 3819 Faber Terrace, Waterford, MI 48328 | 2017-06-15 |
| 1922537364 | Lourdes Alzheimer's Special Care | Custodial Care Facility | 2400 Watkins Lake Rd, Waterford, MI 48328 | 2017-06-08 |
| 1013446459 | Lourdes Assisted Living | Assisted Living Facility | 2450 Watkins Lake Rd, Waterford, MI 48328 | 2017-06-08 |
| 1588019053 | Legacy Dermatology Group PC | Dermatology | 1392 S Cass Lake Rd, Waterford, MI 48328 | 2016-05-03 |
| 1932567989 | Devenia Denise Clayter | Counselor | 255 Summit Dr, Waterford, MI 48328 | 2016-02-05 |
| 1922409739 | Stacey Diggs | Counselor | 250 Elizabeth Lake Road, Biomed Behavorial Healthcare, Waterford, MI 48328 | 2014-09-11 |
| Find all providers in zip 48328 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770117335 | Madeleine Crawford | Physician Assistant | 528 Fairview Cir, Waterford, WI 53185-2874 | 2020-02-23 |
| 1316448186 | Jewels George | Physician Assistant | 3803 Elizabeth Lake Rd, Waterford, MI 48328-3017 | 2018-02-26 |
| 1649553959 | Jamie Rose Rosenthal | Physician Assistant | 6620 Highland Rd Ste 101, Waterford, MI 48327-1682 | 2011-09-22 |
| 1104800903 | Michael H Buchal | Physician Assistant | 2710 Sylvan Shores Dr, Waterford, MI 48328 | 2005-12-05 |
| 1750922100 | Caitlin Anne Ebert | Physician Assistant | 991 Route 19 N Ste B, Waterford, PA 16441-9739 | 2019-10-07 |
| 1083270094 | Anitta Varghese | Physician Assistant | 1901 N Telegraph Rd, Waterford, MI 48328-1878 | 2019-05-15 |
| 1164992285 | Lucy Khalil Hanna | Physician Assistant | 2446 Elizabeth Lake Rd, Waterford, MI 48328-3310 | 2018-12-01 |
| 1427431840 | Julie Zito | Physician Assistant | 196 Parkway S, Suite303, Waterford, CT 06385-1234 | 2015-07-02 |
| 1396177556 | Stephanie Elizabeth Rae Fulton | Physician Assistant | 4800 Highland Rd, Waterford, MI 48328-1176 | 2013-07-30 |
| 1902101140 | Tiffany M Ickiewicz | Physician Assistant | 991 Route 19 N Ste B, Waterford, PA 16441-9739 | 2011-01-19 |
| Find all providers in WATERFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.