MR. KEVIN MICHAEL FORDELL (NPI# 1417107822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417107822 |
| Entity Type | Individual |
| Full Name | MR. KEVIN MICHAEL FORDELL |
| Credential | P.A. |
| Practice Address |
2550 N Thunderbird Cir Ste 303 Mesa AZ 85215-1219 |
| Mailing Address |
77 W Coolidge St Apt 115 Phoenix AZ 85013-2737 |
| Practice Telephone | 4809248382 |
| Practice Fax Number | 4809248399 |
| Mailing Telephone | 6025024621 |
| Enumeration Date | 2008-09-22 |
| Last Update Date | 2008-09-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2550 N THUNDERBIRD CIR STE 303 |
| City | MESA |
| State | AZ |
| Zip Code | 85215-1219 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538155874 | Christine Ann Cary | Physician Assistant | 2550 N Thunderbird Cir Ste 303, Mesa, AZ 85215-1219 | 2005-09-22 |
| 1467085191 | Rebecca Pacheco Fleming | Physician Assistant | 2550 N Thunderbird Cir Ste 303, Mesa, AZ 85215-1219 | 2020-02-21 |
| 1851827901 | Brian K Eggen | Nurse Practitioner | 2550 N Thunderbird Cir Ste 303, Mesa, AZ 85215-1219 | 2017-05-11 |
| 1831647122 | Nextcare Urgent Care | Physician Assistant | 2550 N Thunderbird Cir Ste 303, Mesa, AZ 85215-1219 | 2016-09-14 |
| 1538537782 | Christopher S Cardwell | Physician Assistant | 2550 N Thunderbird Cir Ste 303, Mesa, AZ 85215-1219 | 2015-09-04 |
| 1497007926 | Britany Lewis | Physician Assistant | 2550 N Thunderbird Cir Ste 303, Mesa, AZ 85215-1219 | 2012-10-08 |
| 1316241649 | Shamina Khan | Physician Assistant | 2550 N Thunderbird Cir Ste 303, Mesa, AZ 85215-1219 | 2010-12-30 |
| 1477511764 | Linda Sinat Som | Family Medicine | 2550 N Thunderbird Cir Ste 303, Mesa, AZ 85215-1219 | 2006-05-03 |
| 1811966856 | Clifford J. Guss | Physician Assistant | 2550 N Thunderbird Cir Ste 303, Mesa, AZ 85215-1219 | 2006-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093355356 | Kristen Eldridge | Counselor | 2929 N. Power Rd. Suite 101, Mesa, AZ 85215 | 2020-01-14 |
| 1063062149 | Makenna Francis | Nurse Practitioner | 2730 S. Val Vista Dr, 146, Mesa, AZ 85215 | 2019-09-19 |
| 1487200481 | Royalty Home Care Solutions, LLC | Assisted Living Facility | 6551 E. Menlo St, Mesa, AZ 85215 | 2019-08-15 |
| 1083170641 | Mylena Dashaun Smith | Psychologist | 2812 N. Norwalk St Bldg. 14, Ste 127 & 128, Mesa, AZ 85215 | 2019-02-19 |
| 1487134789 | Arizona Dental Professionals, P.C. | Dentist | 3218 N Recker Rd, Mesa, AZ 85215 | 2018-08-16 |
| 1619463494 | Compassion Care Home, LLC | Private Vehicle | 2863 N 64th Street, Mesa, AZ 85215 | 2018-07-05 |
| 1407293491 | Courtney D Warren | Physical Therapist | 2837 N Power Rd Ste 109, Mesa, AZ 85215 | 2013-05-30 |
| 1104182906 | Kirstin Anna Correia | Naturopath | 3405 N Higley Rd, Mesa, AZ 85215 | 2012-04-05 |
| 1154609683 | Cristy Lee Hoge | Pharmacist | 2151 N. Power Rd., Mesa, AZ 85215 | 2011-08-02 |
| 1699067546 | Fredrick G. Johnson | Registered Nurse | 4320 E Presidio St, #101, Mesa, AZ 85215 | 2011-05-11 |
| Find all providers in zip 85215 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033734686 | Joshua Luke Adams | Physician Assistant | 5264 E Carol Ave, Mesa, AZ 85206-1304 | 2020-06-09 |
| 1508417957 | Joe Panelli | Physician Assistant | 524 S 88th St, Mesa, AZ 85208-8213 | 2019-09-26 |
| 1275183600 | Allie Finney | Physician Assistant | 4135 S Power Rd Ste 129, Mesa, AZ 85212-3627 | 2019-09-17 |
| 1972158459 | Jason Pearce | Physician Assistant | 8334 E Peralta Ave, Mesa, AZ 85212-1677 | 2019-08-01 |
| 1265086409 | Madison Ziser | Physician Assistant | 2604 E Downing Cir, Mesa, AZ 85213-6824 | 2019-07-25 |
| 1790341170 | Mark William Nelms | Physician Assistant | 4839 S Antonio, Mesa, AZ 85212-5191 | 2019-05-11 |
| 1235607292 | Amber Leeann Valenzuela | Physician Assistant | 2345 E Southern Ave Unit 101, Mesa, AZ 85204-5419 | 2018-11-07 |
| 1417423146 | Neda Yasmin Yanch | Physician Assistant | 2505 N Raven Cir, Mesa, AZ 85207-2063 | 2018-10-20 |
| 1336615590 | Nicholas J. Deyoung | Physician Assistant | 5058 E Southern Ave Ste 102, Mesa, AZ 85206-2771 | 2018-10-15 |
| 1417432063 | Jordan Tyler Foulger | Physician Assistant | 3248 E Jacinto Ave, Mesa, AZ 85204-7336 | 2018-09-29 |
| Find all providers in MESA | ||||
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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.