JAMIE L GOTHBERG (NPI# 1235605833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235605833 |
| Entity Type | Individual |
| Full Name | JAMIE L GOTHBERG |
| Credential | NP |
| Practice Address |
1120 E Michigan Ave Ste A Lansing MI 48912-1810 |
| Mailing Address |
Po Box 13008 Lansing MI 48901-3008 |
| Practice Telephone | 5173649790 |
| Practice Fax Number | 5173649791 |
| Mailing Telephone | 5173649790 |
| Mailing Fax Number | 5173649791 |
| Enumeration Date | 2018-10-22 |
| Last Update Date | 2018-10-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
4704276419 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1120 E MICHIGAN AVE STE A |
| City | LANSING |
| State | MI |
| Zip Code | 48912-1810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316563646 | Shelley Gabel | Surgery | 1200 E Michigan Ave., Sparrow Professional Building Suite 655, Lansing, MI 48912 | 2020-06-23 |
| 1568087237 | Ahmed Mohamed Haggag | Student in an Organized Health Care Education/Training Program | 1215 East Michigan Avenue 3rd Floor, Lansing, MI 48912 | 2020-06-09 |
| 1467074773 | Craig Hargurkirat Malli | Family Medicine | 1215 E Michigan Avenue Suite 245, Lansing, MI 48912 | 2020-05-08 |
| 1215558945 | Temmy J. Brotherson | Family Medicine | Sparrow Health Systems, 1200 E Michigan Avenues, Suite 245, Lansing, MI 48912 | 2020-05-05 |
| 1386265452 | Kyle Patrick Doran | Emergency Medicine | Sparrow Health System, 1215 E Michigan Avenue, Lansing, MI 48912 | 2020-04-30 |
| 1316418841 | Andrea Mcswain Do PC | Obstetrics & Gynecology | 1909 E. Michigan Ave, Lansing, MI 48912 | 2018-12-10 |
| 1215386115 | Michael Vernon Hollis | Student in an Organized Health Care Education/Training Program | 1500 E Michigan Ave, Suite 655, Lansing, MI 48912 | 2016-06-10 |
| 1518333970 | Eastside Community Action Center | Social Worker | 1001 Dakin Street, Suite B, Lansing, MI 48912 | 2015-08-19 |
| 1649667403 | Cheryl Ann Wade | Counselor | 1712 E Michigan Ave., Lansing, MI 48912 | 2015-04-20 |
| 1083006134 | Carol Pratt | Occupational Therapist | 1200 E. Michigan Ave, Outpatient Rehab - Lower Level, Lansing, MI 48912 | 2015-02-26 |
| Find all providers in zip 48912 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710597281 | Adepeju Ojomalade | Nurse Practitioner | 2327 184th Pl, Lansing, IL 60438-2614 | 2020-08-08 |
| 1932731890 | Jaymi D Nesbit | Nurse Practitioner | 3131 Boston Blvd, Lansing, MI 48910-6504 | 2020-02-10 |
| 1114560539 | Michele Junious Lyons | Nurse Practitioner | 1631 185th St, Lansing, IL 60438-6508 | 2019-10-18 |
| 1659931418 | Kayla Holcomb | Nurse Practitioner | 3701 173rd Ct Apt 3c, Lansing, IL 60438-1441 | 2019-06-14 |
| 1033604954 | Kenisha Davis | Nurse Practitioner | 18232 Ridgewood Ave, Lansing, IL 60438-3024 | 2018-06-23 |
| 1538677026 | Harold F. Roth, D.o. | Nurse Practitioner | 1627 Lake Lansing Rd Ste 200, Lansing, MI 48912-3788 | 2018-01-18 |
| 1023491875 | Katelyn Donofrio | Nurse Practitioner | 107 N Washington Sq, Lansing, MI 48933-1777 | 2015-06-29 |
| 1578966594 | Michele Marie Toney | Nurse Practitioner | 3618 176th Pl, Lansing, IL 60438-2035 | 2014-10-04 |
| 1134544190 | Stephanie Michele Stanley | Nurse Practitioner | 232 Bittersweet Ln, Lansing, KS 66043-1403 | 2014-02-28 |
| 1225169261 | Angela Christine Berg | Nurse Practitioner | 102 Mcpherson Ave, Lansing, MI 48915-1760 | 2007-03-09 |
| Find all providers in LANSING | ||||
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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.