JACK E. REDDING II (NPI# 1295843852) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295843852 |
| Entity Type | Individual |
| Full Name | JACK E. REDDING II |
| Credential | PA-C |
| Practice Address |
11835 Rt 9w West Coxsackie NY 12192-3605 |
| Mailing Address |
60 Martins Hill Rd Ravena NY 12143-2809 |
| Practice Telephone | 5187319000 |
| Practice Fax Number | 5187319119 |
| Mailing Telephone | 5186942965 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2015-03-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA9100926 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
11835 RT 9W |
| City | WEST COXSACKIE |
| State | NY |
| Zip Code | 12192-3605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073593927 | Daniel R Wiest | Emergency Medicine | 11835 Rt 9w, West Coxsackie, NY 12192-3605 | 2006-01-18 |
| 1326654633 | Kortney Rose Smith | Physician Assistant | 11835 Rt 9w, West Coxsackie, NY 12192-3605 | 2020-09-22 |
| 1609369180 | Rachael M Mccormick | Physician Assistant | 11835 Rt 9w, West Coxsackie, NY 12192-3605 | 2018-06-11 |
| 1629420807 | Mei Yu Ren | Physician Assistant | 11835 Rt 9w, West Coxsackie, NY 12192-3605 | 2016-07-12 |
| 1144671371 | Kristyn Joelle Cuomo | Physician Assistant | 11835 Rt 9w, West Coxsackie, NY 12192-3605 | 2016-06-29 |
| 1275964322 | Albany Medical College | Emergency Medicine | 11835 Rt 9w, West Coxsackie, NY 12192-3605 | 2013-11-27 |
| 1366872244 | Albany Medical College | Emergency Medicine | 11835 Rt 9w, West Coxsackie, NY 12192-3605 | 2013-11-14 |
| 1982040887 | Cindy Coons | Physician Assistant | 11835 Rt 9w, West Coxsackie, NY 12192-3605 | 2013-05-17 |
| 1629352828 | Erin Grogan Deeb | Physician Assistant | 11835 Rt 9w, West Coxsackie, NY 12192-3605 | 2011-10-06 |
| 1649590365 | Lauren Blaisdell | Physician Assistant | 11835 Rt 9w, West Coxsackie, NY 12192-3605 | 2010-06-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801433941 | Jolene Marie Yost | Massage Therapist | 11831 Us 9w, West Coxsackie, NY 12192 | 2019-12-09 |
| 1093190555 | Erin Kimberly Smith I | Physical Therapist | 11831 Us-9w, West Coxsackie, NY 12192 | 2015-07-27 |
| 1639402639 | Northland Hearing Centers, Inc. | Audiologist-Hearing Aid Fitter | 9 Law Street, West Coxackie, NY 12192 | 2009-09-09 |
| 1477714236 | Marvin A. Gertzberg, D.d.s. | Dentist | 12498 Us Rte 9w, West Coxsackie, NY 12192 | 2008-06-24 |
| 1518091818 | John R Riker Dc Pllc | Chiropractor | 11824 Rt. 9w, Suite 2, W. Coxsackie, NY 12192 | 2007-03-16 |
| 1467520676 | Alan Palmer | Physical Therapist | 11831 Route 9w, W. Coxsackie, NY 12192 | 2006-12-04 |
| 1053703264 | Hudson Valley Foot Associates, LLP | Podiatrist | 28 Hope Plz, W Coxsackie, NY 12192-1225 | 2015-02-25 |
| 1396753398 | Hoerning Pharmacy Inc | Pharmacy | 34 Hope Plz, West Coxsackie, NY 12192-1225 | 2006-08-04 |
| 1902215213 | Kellys Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 34 Hope Plz, West Coxsackie, NY 12192-1225 | 2014-08-12 |
| 1831516442 | Hoerning Pharma Inc | Pharmacy | 34 Hope Plz, West Coxsackie, NY 12192-1225 | 2014-03-20 |
| Find all providers in zip 12192 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154870053 | Kathryn Falco | Physician Assistant | 11835 9w, West Coxsackie, NY 12192-3605 | 2016-10-03 |
| 1477007540 | Margarita Malayeva | Physician Assistant | 11835 9w, West Coxsackie, NY 12192-3605 | 2016-08-06 |
| 1629420807 | Mei Yu Ren | Physician Assistant | 11835 Rt 9w, West Coxsackie, NY 12192-3605 | 2016-07-12 |
| 1699127910 | Nicole Elizabeth Riley | Physician Assistant | 11835 9w, West Coxsackie, NY 12192-3605 | 2016-07-11 |
| 1144671371 | Kristyn Joelle Cuomo | Physician Assistant | 11835 Rt 9w, West Coxsackie, NY 12192-3605 | 2016-06-29 |
| 1053506063 | Christopher Paul Barela | Physician Assistant | 11835 Rt 9w, West Coxsackie, NY 12192-3605 | 2007-09-12 |
| 1730140179 | Earl Dawkins | Physician Assistant | 11835 Rt 9w, West Coxsackie, NY 12192-3605 | 2006-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487252581 | North Shore Medical Group Pllc | Physician Assistant | 311 Skyview Ter, Syracuse, NY 13219-2835 | 2020-10-12 |
| 1477169654 | Kristen Ariel O'connell | Physician Assistant | 85 John St Apt 7a, New York, NY 10038-2844 | 2020-09-22 |
| 1699381616 | David Nmn Kao | Physician Assistant | 737 Pleasant Avenue, Westbury, NY 11590-6407 | 2020-09-16 |
| 1043824816 | Elizabeth Keane | Physician Assistant | 25 Hollis Dr, Sound Beach, NY 11789-1629 | 2020-08-31 |
| 1497364111 | Tianna Stephens | Physician Assistant | 165 N Village Ave Ste 5, Rockville Centre, NY 11570-3701 | 2020-07-28 |
| 1124636188 | Shannon Maureen O'connell | Physician Assistant | 270-05 270th Ave, New Hyde Park, NY 11040 | 2020-07-16 |
| 1841818895 | Yanick Dugue | Physician Assistant | 4 Lincoln Ave, New Hyde Park, NY 11040-3125 | 2020-07-07 |
| 1194340505 | Kayleigh Marie Tourt | Physician Assistant | 222 Alexander St Fl 4, Rochester, NY 14607-4039 | 2020-06-11 |
| 1023638509 | Kristina Rajic | Physician Assistant | 7237 66th Dr, Flushing, NY 11379-2111 | 2020-04-24 |
| 1114547791 | Michele Hein | Physician Assistant | 700 Veterans Memorial Hwy, Hauppauge, NY 11788-2952 | 2020-04-23 |
| Find all providers with the same taxonomy | ||||
| City | WEST COXSACKIE |
| Zip Code | 12192 |
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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.