JEREMY MICHAEL NICOSKI (NPI# 1336786078) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336786078 |
| Entity Type | Individual |
| Full Name | JEREMY MICHAEL NICOSKI |
| Practice Address |
500 Campus Dr Hancock MI 49930-1452 |
| Mailing Address |
1922 Whippoorwill Way Sartell MN 56377-4706 |
| Practice Telephone | 9064831516 |
| Mailing Telephone | 3204931477 |
| Enumeration Date | 2019-12-02 |
| Last Update Date | 2019-12-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 4704334699 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
500 CAMPUS DR |
| City | HANCOCK |
| State | MI |
| Zip Code | 49930-1452 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215931068 | Portage Health Inc | Emergency Medicine | 500 Campus Dr, Hancock, MI 49930-1569 | 2005-06-09 |
| 1376182931 | Melissa Sue Meier | Nurse Practitioner | 500 Campus Dr, Hancock, MI 49930-1452 | 2019-12-31 |
| 1548805005 | Shana Louise Roth | Dietitian, Registered | 500 Campus Dr, Hancock, MI 49930-1452 | 2019-11-08 |
| 1902365752 | Natalie Sloan Hupp | Physical Therapist | 500 Campus Dr, Hancock, MI 49930-1452 | 2019-03-19 |
| 1891267571 | Jenny Dice | Pharmacist | 500 Campus Dr, Hancock, MI 49930-1452 | 2018-12-19 |
| 1700354149 | Jessie Rae Salo | Nurse Practitioner | 500 Campus Dr, Hancock, MI 49930-1452 | 2018-11-04 |
| 1154806206 | Brittany Andrianna Wadaga | Registered Nurse | 500 Campus Dr, Hancock, MI 49930-1452 | 2018-09-25 |
| 1417442898 | Concierge Dermatology & Skin Surgery Center | Dermatology | 500 Campus Dr, Hancock, MI 49930 | 2018-06-27 |
| 1306343918 | Stephanie Bustos | Physical Therapist | 500 Campus Dr, Hancock, MI 49930-1452 | 2018-04-10 |
| 1477057230 | Amanda Kilpela | Speech-Language Pathologist | 500 Campus Dr, Hancock, MI 49930-1452 | 2018-03-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437627643 | Karen Byrnes | Registered Nurse | Hancock Va Cboc, 787 Market St. Suite 9, Hancock, MI 49930 | 2018-11-06 |
| 1881117562 | Angelica Monique Nunez | Specialist/Technologist | 601 Quincy St, Hancock, MI 49930 | 2017-07-25 |
| 1831581164 | Superior Prosthetics and Orthotics | Prosthetic/Orthotic Supplier | 20075 Third Street, Hancock, MI 49930 | 2015-02-24 |
| 1861703258 | Superior Smiles | Dentist | 1550 West Quincy St, Hancock, MI 49930 | 2010-06-30 |
| 1164633780 | Kathryn Mary Salmi | Counselor | 100 Quincy Street, Hancock, MI 49930 | 2007-05-25 |
| 1093828535 | Mary Katherine Van Camp | Social Worker | 787 Market St., Suites 9 & 10, Hancock, MI 49930 | 2006-08-17 |
| 1083627392 | Kim Kathleen Green | Social Worker | 787 Market Street, Hancock, MI 49930 | 2006-08-15 |
| 1346257672 | James William Sarazin | Dentist | 528 Quincy Street, Hancock, MI 49930 | 2006-08-01 |
| 1114951829 | Patricia J Tikkanen | Social Worker | 200 Michigan St Ste 321, Hancock, MI 49930 | 2006-07-10 |
| 1487639829 | Thomas Collins | Social Worker | 920 Water Street, Hancock, MI 49930 | 2005-12-08 |
| Find all providers in zip 49930 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891133559 | Kristen Tweedy | Nurse Anesthetist, Certified Registered | 500 Campus Dr, Hancock, MI 49930-1452 | 2013-06-04 |
| 1861740177 | Louis A Dubois | Nurse Anesthetist, Certified Registered | 500 Campus Dr, Hancock, MI 49930-1569 | 2012-08-16 |
| 1528181146 | Timothy Andress | Nurse Anesthetist, Certified Registered | 500 Campus Dr, Hancock, MI 49930-1569 | 2007-04-09 |
| 1043360431 | Michael Conrad Salmi | Nurse Anesthetist, Certified Registered | 500 Campus Dr, Hancock, MI 49930-1569 | 2007-01-10 |
| 1437220621 | Stephen Lee Webber | Nurse Anesthetist, Certified Registered | 500 Campus Dr, Hancock, MI 49930-1569 | 2006-11-11 |
| 1790729762 | Brian L Brant | Nurse Anesthetist, Certified Registered | 500 Campus Dr, Hancock, MI 49930-1452 | 2006-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615986 | Toleka Regina Taylor | Nurse Anesthetist, Certified Registered | St. John Macomb Hospital, 11800 East 12 Mile Road, Warren, MI 48093 | 2020-10-05 |
| 1245850957 | Black River Anesthesia Staffing LLC | Nurse Anesthetist, Certified Registered | 7245 Baseline Rd, South Haven, MI 49090-9176 | 2020-04-22 |
| 1669008017 | Kalin Elizabeth Wade | Nurse Anesthetist, Certified Registered | 4485 Kenneth Dr Apt C207, Okemos, MI 48864-1900 | 2020-03-18 |
| 1215568340 | Complete Ketamine Inc | Nurse Anesthetist, Certified Registered | 98 Winchester St, Monroe, MI 48161-1957 | 2020-01-28 |
| 1730729740 | Pride Mudzwova | Nurse Anesthetist, Certified Registered | 57693 Dakota Dr, New Hudson, MI 48165-9336 | 2020-01-08 |
| 1982249041 | Leif Elias | Nurse Anesthetist, Certified Registered | 3443 Oak Dr, Ann Arbor, MI 48105-9798 | 2019-11-13 |
| 1619512779 | Yvonne Marie Bridgeford | Nurse Anesthetist, Certified Registered | 2113 Mason Rd, Howell, MI 48843-8903 | 2019-11-13 |
| 1184269243 | Jaclyn Rochefort | Nurse Anesthetist, Certified Registered | 5381 Frovan Pl, Saginaw, MI 48638-5573 | 2019-11-13 |
| 1932744091 | Sean S Vanderwaal | Nurse Anesthetist, Certified Registered | 1420 Perry Rd Apt 1-8, Grand Blanc, MI 48439-1727 | 2019-11-13 |
| 1467093153 | Apollo Medical Group of Traverse City Pllc | Nurse Anesthetist, Certified Registered | 3663 N Country Dr, Traverse City, MI 49684-4587 | 2019-10-03 |
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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.