DIMA SPRAGUE (NPI# 1275872376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275872376 |
| Entity Type | Individual |
| Full Name | DIMA SPRAGUE |
| Practice Address |
28800 Ryan Rd Warren MI 48092-4272 |
| Mailing Address |
6924 Appoline St Upper Level Dearborn MI 48126-1989 |
| Practice Telephone | 5865779444 |
| Enumeration Date | 2013-02-08 |
| Last Update Date | 2017-02-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 5601006517 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
5601006517 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
28800 RYAN RD |
| City | WARREN |
| State | MI |
| Zip Code | 48092-4272 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710967815 | Gary G Gilyard | Orthopaedic Surgery | 28800 Ryan Rd, Suite 280, Warren, MI 48092-4272 | 2006-01-17 |
| 1982055943 | Melissa Wummel | Social Worker | 28800 Ryan Rd, Ste 320, Warren, MI 48092-4272 | 2016-06-30 |
| 1477920510 | Yasmin Keshavjee | Family Medicine | 28800 Ryan Rd, Suite 320, Warren, MI 48092-4272 | 2015-08-24 |
| 1033502224 | Neurocognitive Center of Michigan Group | Psychologist | 28800 Ryan Rd, Suite 300, Warren, MI 48092-4272 | 2015-03-11 |
| 1801207907 | Kathryn Aurand | Physician Assistant | 28800 Ryan Rd, Suite 280, Warren, MI 48092-4272 | 2014-05-12 |
| 1952721862 | Samantha Reichling | Specialist | 28800 Ryan Rd, Warren, MI 48092-4272 | 2014-04-17 |
| 1700204328 | Neurocognitive Center of Michigan Inc. | Psychologist | 28800 Ryan Rd, Suite 320, Warren, MI 48092-4272 | 2014-04-01 |
| 1487081782 | Sara Louise Blomeling-deroo | Social Worker | 28800 Ryan Rd, Suite 320, Warren, MI 48092-4272 | 2013-10-01 |
| 1568712370 | Behavioral Infermiera Care Solutions Inc | Psychologist | 28800 Ryan Rd, Suite 320, Warren, MI 48092-4272 | 2012-09-19 |
| 1932455599 | Kaitlyn Elizabeth Hefferan | Physician Assistant | 28800 Ryan Rd, Warren, MI 48092-4272 | 2012-07-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881163186 | Katherine Byrd | Behavior Technician | 3691 East 11 Mile Rd., Warren, MI 48092 | 2018-11-15 |
| 1861980302 | Mark Paul Azzo | Home Health Aide | 27605 Walker Ave, Warren, MI 48092 | 2018-04-30 |
| 1144747130 | Joseph Galutan Estrada | Chiropractor | 4846 Marlow Dr, Warren, MI 48092 | 2017-08-29 |
| 1649669425 | Lawrence Mosurak IIi | Chiropractor | 6201 Chicago Road, Warren, MI 48092 | 2015-01-15 |
| 1174911713 | Kimberly A Ott | Nurse Practitioner | 28800 Ryan Rd Suite 320, Warren, MI 48092 | 2015-01-06 |
| 1487071999 | Michele Szandzik | Chiropractor | 2243 East 12 Mile Rd, Warren, MI 48092 | 2014-03-21 |
| 1962827311 | Mouradian Dental Center, D.d.s., P.C. | Dentist | 32500 Mound Rd., Mouradian Dental Center, D.d.s., P.C., Warren, MI 48092 | 2014-02-21 |
| 1639495930 | Debra Kay Wenneman | Physical Therapist | 28776 Ryan Rd, Warren, MI 48092 | 2010-04-12 |
| 1922332923 | Sonia Amirali Pethani | Physical Therapist | 2117 E. Eleven Mile Rd., Warren, MI 48092 | 2009-09-23 |
| 1881822237 | Michael Patrick Walsh | Orthopaedic Surgery | 28800 Ryan Rd Ste 310, Warren, MI 48092 | 2009-06-24 |
| Find all providers in zip 48092 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013452622 | Larae Tymochko | Physician Assistant | 1350 E Market St, Warren, OH 44483-6608 | 2017-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841835303 | Gerard M Lefebvre Jr. | Physician Assistant | 5301 Mcauley Dr Ste 5112, Ypsilanti, MI 48197-1051 | 2019-11-08 |
| 1548611023 | Michael Scott Schaeffer II | Physician Assistant | 58070 Montego Dr, New Hudson, MI 48165-9735 | 2016-06-27 |
| 1700248176 | Katilyn Kohl | Physician Assistant | 3990 John R St Ste 4905, Detroit, MI 48201-2018 | 2016-03-24 |
| 1881052363 | Surgical Assist, Plc | Physician Assistant | 4409 Gaylord Dr, Troy, MI 48098-4458 | 2016-01-29 |
| 1710342134 | Evan Reid Vandenbosch | Physician Assistant | 36622 5 Mile Rd, Suite 101, Livonia, MI 48154-1900 | 2015-12-30 |
| 1619368008 | Matthew Eisen | Physician Assistant | 1560 E Sherman Blvd Ste 9, Muskegon, MI 49444-1867 | 2015-02-06 |
| 1609214972 | Jennifer Lynn Krishnan | Physician Assistant | 3601 E 13 Mile Rd, Royal Oak, MI 48073-6769 | 2013-06-10 |
| 1093028441 | Lonna Petronella Van Ast | Physician Assistant | 1022 Ada Place Dr Se, Grand Rapids, MI 49546-3786 | 2010-07-14 |
| 1669707170 | Luke Thomas Dillon | Physician Assistant | 3100 Cross Creek Pkwy Ste 200, Auburn Hills, MI 48326-2776 | 2009-10-16 |
| 1912139544 | Richard Lawrence Burgett Sr. | Physician Assistant | 4327 Stone Ridge Dr, Traverse City, MI 49684-7958 | 2009-08-15 |
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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.