JTDM FAMILY PRACTICE LLC (NPI# 1447288717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447288717 |
| Entity Type | Organization |
| Organization Name | JTDM FAMILY PRACTICE LLC |
| Other Organization Name | GRAND LAKE OB/GYN |
| Practice Address |
1067 Hager St St Marys OH 45885-2422 |
| Practice Telephone | 4193947314 |
| Practice Fax Number | 4193947313 |
| Mailing Telephone | 4193947314 |
| Mailing Fax Number | 4193947313 |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2014-01-03 |
| Authorized Official Name | JEFFREY W. VOSSLER (VICE PRESIDENT OF FINANCIAL SERVICE) |
| Authorized Official Telephone | 4193943335 |
| Is Organization Subpart | Y |
| Parent Organization Name | JTDM FAMILY PRACTICE LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2821558 | 05 | |
| OH | MEDICARE PTAN | 9934724 | 01 |
| Other Name | Type Code |
|---|---|
| Grand Lake OB/GYN | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164602678 | Jtdm Family Practice LLC | Family Medicine | 4 Eagle Dr, Minster, OH 45865-9714 | 2007-11-13 |
| 1639114192 | Jtdm Family Practice LLC | Otolaryngology | 1165 S Knoxville Ave, Suite F, St Marys, OH 45885-2622 | 2006-06-18 |
| 1750937090 | Jtdm Family Practice LLC | Durable Medical Equipment & Medical Supplies | 1013 E Spring St, Saint Marys, OH 45885-2447 | 2019-08-13 |
| 1932670023 | Jtdm Family Practice LLC | Durable Medical Equipment & Medical Supplies | 123 Hamilton St, Celina, OH 45822-1909 | 2018-12-16 |
| 1356772255 | Jtdm Family Practice LLC | Family Medicine | 812 Redskin Trl, Wapakoneta, OH 45895-8545 | 2013-12-03 |
| 1689005761 | Jtdm Family Practice LLC | Physician Assistant | 801 Pro Dr, Celina, OH 45822-3307 | 2013-11-27 |
| 1942630348 | Jtdm Family Practice LLC | Pediatrics | 801 Pro Dr, Celina, OH 45822-3307 | 2013-11-21 |
| 1104024546 | Jtdm Family Practice LLC | Family Medicine | 4463 State Route 66, Minster, OH 45865-8727 | 2007-07-06 |
| 1184652539 | Jtdm Family Practice LLC | Nurse Practitioner | 200 Saint Clair Ave, St Marys, OH 45885-2400 | 2006-06-28 |
| 1144257759 | Jtdm Family Practice LLC | Psychiatry & Neurology | 1165 S Knoxville Ave, Suite F, St Marys, OH 45885-2622 | 2006-06-27 |
| Street Address |
1067 HAGER ST |
| City | ST MARYS |
| State | OH |
| Zip Code | 45885-2422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083232417 | Dimensional Wellness LLC | Counselor | 150 1/2 E. High St., Saint Marys, OH 45885 | 2020-07-13 |
| 1124679519 | Wishing Well Clinic & Spa, LLC | Massage Therapist | 153 E, Spring Street, St Marys, OH 45885 | 2019-09-26 |
| 1720633639 | Grand Lake Operations, LLC | Assisted Living Facility | 1035 Hager Street, Saint Marys, OH 45885 | 2019-08-07 |
| 1225436439 | Sharon Schnell | Pharmacist | 200 St. Clair Ave, St. Marys, OH 45885 | 2014-12-22 |
| 1851692669 | Gregory J Walter | Pharmacist | 1052 E. Spring St., St. Marys, OH 45885 | 2010-11-10 |
| 1578708053 | St Marys City Board of Education | Local Education Agency (LEA) | 2250 State Route 66, Saint Marys, OH 45885 | 2008-12-11 |
| 1104098037 | Alliance for Women's Health Inc | Obstetrics & Gynecology | 510 East Spring Street, St Marys, OH 45885 | 2008-04-01 |
| 1598869646 | Pajka Eye Center Inc | Ophthalmology | 200 St Clair, Joint Township District Memorial Hospital, St Marys, OH 45885 | 2006-09-11 |
| 1487664306 | Chalasani Md Inc. | Internal Medicine | 1300 Greenville Rd., St. Marys, OH 45885 | 2006-08-09 |
| 1821007949 | Kenneth Lance Bryant | Surgery | 1300 Greenville Rd Ste B, Saint Marys, OH 45885 | 2006-08-07 |
| Find all providers in zip 45885 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104098037 | Alliance for Women's Health Inc | Obstetrics & Gynecology | 510 East Spring Street, St Marys, OH 45885 | 2008-04-01 |
| 1225138696 | St Marys Womens Health Care PC | Obstetrics & Gynecology | 761 Johnsonburg Rd, Ste 220, St Marys, PA 15857 | 2006-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952917973 | Complete Care for Women | Obstetrics & Gynecology | 99 North Brice Rd, Suite 320, Columbus, OH 43213 | 2020-09-16 |
| 1366086761 | Women's Integrative Medicine Obgyn LLC | Obstetrics & Gynecology | 477 Cooper Rd Ste 320, Westerville, OH 43081-6045 | 2019-10-30 |
| 1700437266 | Obstetrics and Gynecology South, Inc | Obstetrics & Gynecology | 700 S Stanfield Rd Ste B, Troy, OH 45373-2569 | 2019-09-26 |
| 1407414386 | Ronald James Thompson Md | Obstetrics & Gynecology | 2200 Victory Pkwy Apt 1602, Cincinnati, OH 45206-2824 | 2019-06-05 |
| 1043876394 | Rachel K Booth | Obstetrics & Gynecology | 128 E Apple St Ste 3800d, Dayton, OH 45409-2902 | 2019-05-13 |
| 1871060608 | Ahmed Shahata | Obstetrics & Gynecology | Ashtabula County Medical Center/obgyn Dept, 2420 Lake Ave, Ashtabula, OH 44004 | 2018-10-30 |
| 1992204432 | Catherine Nowak | Obstetrics & Gynecology | 1611 S Green Rd Ste 238, South Euclid, OH 44121-4123 | 2018-02-11 |
| 1649786963 | Columbus Obstetric and Gynecology Center | Obstetrics & Gynecology | 340 E Town St Ste 8900, Columbus, OH 43215-4646 | 2017-12-22 |
| 1538673090 | Healthy Beginnings Inc | Obstetrics & Gynecology | 1230 W Kemper Rd, Cincinnati, OH 45240-1618 | 2017-11-20 |
| 1568989762 | Women's Health for Life, Inc. | Obstetrics & Gynecology | 1220 E Elm St Ste 204, Lima, OH 45804-2898 | 2017-08-28 |
| Find all providers with the same taxonomy | ||||
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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.