JAMIE BRACKENRICH (NPI# 1356953053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356953053 |
| Entity Type | Individual |
| Full Name | JAMIE BRACKENRICH |
| Other Name | JAMIE LEIGH SHRADER |
| Credential | FNP |
| Practice Address |
6994 Dawnwood Rd Roanoke VA 24018-6839 |
| Practice Telephone | 5403120105 |
| Mailing Telephone | 5403120105 |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2020-08-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024179822 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | VIRGINIA BOARD OF NURSING | 0024179822 | 01 |
| Street Address |
6994 DAWNWOOD RD |
| City | ROANOKE |
| State | VA |
| Zip Code | 24018-6839 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770140253 | Luz Dione Carr | Nurse Practitioner | 1934 Maple Leaf Drive, Roanoke, VA 24018 | 2019-05-21 |
| 1467926527 | Embrace Foster Care, LLC | Foster Care Agency | 3912 Electric Road, Building C, Roanoke, VA 24018 | 2019-01-11 |
| 1174005417 | Roanoke Valley Ent & Allergy PC | Otolaryngology | 2154 Mcvitty Rd, Second Floor, Roanoke, VA 24018 | 2018-09-04 |
| 1265928535 | Jane Willis Warner | Behavior Technician | 3243 Electric Road Building E Suite 1b, Roanoke, VA 24018 | 2018-07-10 |
| 1821584640 | Anchor To Hope Counseling LLC | Counselor | 4370 Starkey Rd Ste 4c-1, Roanoke, VA 24018 | 2018-07-04 |
| 1164938619 | Aurora Domangue | Behavior Technician | 3243 Electric Road, Building E Suite 1b, Roanoke, VA 24018 | 2017-12-20 |
| 1376059089 | Maggie Marie Ridgeway | Behavior Technician | 3243 Electric Rd., Building E Suite 1b, Roanoke, VA 24018 | 2017-12-18 |
| 1700301850 | Nicole Graboski | Speech-Language Pathologist | 4920 Woodmar Drive Sw, Roanoke, VA 24018 | 2017-08-10 |
| 1891215893 | Kimberly Anne Rosenberger | Occupational Therapy Assistant | 2772 Hillbrook Dr., Roanoke, VA 24018 | 2017-06-21 |
| 1083158950 | Encompass Home Health of Roanoke, LLC | Home Health | 5115 Bernard Drive, Suite 205, Roanoke, VA 24018 | 2016-12-13 |
| Find all providers in zip 24018 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225638026 | Prasanti Pinnamaraju | Nurse Practitioner | 5324 Fox Ridge Rd, Roanoke, VA 24018-8754 | 2020-10-29 |
| 1912512856 | Jennifer Larson | Nurse Practitioner | 8325 Barrens Rd, Roanoke, VA 24019-6701 | 2020-09-08 |
| 1164044608 | Denise Pollock | Nurse Practitioner | 6032 Matisse Ln, Roanoke, VA 24018-5335 | 2020-05-07 |
| 1538703061 | Erin Moyer Shinault | Nurse Practitioner | 3559 Meadowlark Rd, Roanoke, VA 24018-5007 | 2019-10-28 |
| 1972146421 | Amy Rose Gregor | Nurse Practitioner | 15645 Pioneer Bluff Trl, Roanoke, TX 76262-1799 | 2019-10-28 |
| 1811409402 | Victor Cisneros | Nurse Practitioner | 3535 Franklin Rd Sw, Roanoke, VA 24014-2255 | 2017-11-03 |
| 1053841965 | Christin Elledge Clark | Nurse Practitioner | 1234 Franklin Road, Roanoke, VA 24016 | 2017-06-13 |
| 1578009346 | Debra Jean Massaro | Nurse Practitioner | 123 Sesame St., Roanoke, VA 24011 | 2017-01-17 |
| 1407216831 | Keri Lynn Baker | Nurse Practitioner | 1 Riverside Cir Fl 4, Roanoke, VA 24016-4961 | 2016-02-26 |
| 1598134173 | Jessica Van Auken | Nurse Practitioner | 2027 Bloomfield Ave, Roanoke, VA 24012-6775 | 2015-09-24 |
| Find all providers in ROANOKE | ||||
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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.