JENNIFER L. RUCKELSHAUS (NPI# 1528171287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528171287 |
| Entity Type | Individual |
| Full Name | JENNIFER L. RUCKELSHAUS |
| Credential | PA |
| Practice Address |
200 Mission Boulevard Jackson CA 95642-2564 |
| Mailing Address |
Po Box 255228 Sacramento CA 95865-5228 |
| Practice Telephone | 2092237500 |
| Mailing Telephone | 8557710335 |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2020-03-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA13030 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PA13030 | 05 |
| Street Address |
200 MISSION BOULEVARD |
| City | JACKSON |
| State | CA |
| Zip Code | 95642-2564 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093828758 | Gerard V. Bland | Emergency Medicine | 200 Mission Boulevard, Jackson, CA 95642-2564 | 2006-08-16 |
| 1417040619 | Amador Emergency Physicians Medical Group, Inc. | Emergency Medicine | 200 Mission Boulevard, Jackson, CA 95642-2564 | 2006-10-02 |
| 1811000573 | Shawn K. Brady | Emergency Medicine | 200 Mission Boulevard, Jackson, CA 95642-2564 | 2006-08-16 |
| 1720191489 | Bradford J. Chew | Emergency Medicine | 200 Mission Boulevard, Jackson, CA 95642-2564 | 2006-08-16 |
| 1639282395 | Steven C. Gabaeff | Emergency Medicine | 200 Mission Boulevard, Jackson, CA 95642-2564 | 2006-08-16 |
| 1548373202 | Drew D. Hood | Emergency Medicine | 200 Mission Boulevard, Jackson, CA 95642-2564 | 2006-08-16 |
| 1700999463 | Kurt B. Popke | Emergency Medicine | 200 Mission Boulevard, Jackson, CA 95642-2564 | 2006-08-16 |
| 1699888263 | Michael W. Juby | Emergency Medicine | 200 Mission Boulevard, Jackson, CA 95642-2564 | 2006-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932666575 | Gold Country Health Initiative, LLC | Family Medicine | 820/830 State Highway 88, Jackson, CA 95642 | 2019-03-01 |
| 1053844902 | Kathryn Erosa | Pharmacist | 515 Highway 49 South, Jackson, CA 95642 | 2017-04-07 |
| 1356882039 | Thomas Alan Bowhay | Clinic/Center | 820 Highway 88, Jackson, CA 95642 | 2017-03-15 |
| 1710130141 | Roland E Womack | Dentist | 511 Sutter St, Jackson, CA 95642 | 2008-10-29 |
| 1508929522 | Stanley M Ordonez | Dentist | 645 New York Ranch Rd, Jackson, CA 95642 | 2006-12-19 |
| 1942374996 | Thomas W Zeiler | Chiropractor | 665 New York Ranch Rd Suite 2, Jackson, CA 95642 | 2006-11-20 |
| 1023188968 | Cordelia Rose Slayter | Physical Therapist | 711 S State Hwy 49, Jackson, CA 95642 | 2006-11-08 |
| 1285744946 | Raleys | Pharmacy | 781 South Highway 49, Jackson, CA 95642 | 2006-08-30 |
| 1316996747 | Robert R. Bussell X | Physical Therapist | 813 Court Street, Ste 2, Jackon, CA 95642 | 2006-05-10 |
| 1861953135 | Chelsea Yule Solutions | Clinic/Center | 230 N Main St, Jackson, CA 95642 | 2019-03-28 |
| Find all providers in zip 95642 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629206784 | Sarah Beth Poplawski | Physician Assistant | 205 N. East Avenue, Emergency Department, Jackson, MI 49201 | 2009-06-29 |
| 1225167356 | Marianne Elizabeth Lapointe | Physician Assistant | 815 Court St Ste 7, Jackson, CA 95642-2154 | 2007-03-05 |
| 1386780237 | Charles F Harris | Physician Assistant | 982 W. Broadway, Jackson, WY 83002 | 2007-01-29 |
| 1427109149 | Coreen Dian Garcia-sweets | Physician Assistant | 3235 E Michigan Ave Ste 100, Jackson, MI 49202-3971 | 2007-01-16 |
| 1861552556 | Marc A Fierro | Physician Assistant | 11333 Prospect Dr Ste 401, Jackson, CA 95642-9311 | 2006-12-11 |
| 1427146539 | James E Abernathy II | Physician Assistant | 294 Sumar Dr, Jackson, TN 38301 | 2006-10-11 |
| 1184633935 | Kelly Elizabeth Graver Pate | Physician Assistant | 9279 Locust St., Jackson, CA 95669 | 2006-08-07 |
| 1548241359 | Byron Michael Breeding | Physician Assistant | 144 Edenwood Dr, Jackson, TN 38301-3827 | 2005-11-09 |
| 1033735709 | Anna Marie Plumley | Physician Assistant | 1325 N West Ave, Jackson, MI 49202-2050 | 2020-06-18 |
| 1093347072 | Jessica Emil Ansara | Physician Assistant | 205 N East Ave, Jackson, MI 49201-1753 | 2020-02-07 |
| Find all providers in JACKSON | ||||
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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.