CRAIG EUGENE SPONSELLER (NPI# 1578512851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578512851 |
| Entity Type | Individual |
| Full Name | CRAIG EUGENE SPONSELLER |
| Credential | PA-C |
| Practice Address |
3235 E Michigan Ave Jackson MI 49202-3971 |
| Practice Telephone | 5177873280 |
| Practice Fax Number | 5177879680 |
| Mailing Telephone | 5177873280 |
| Mailing Fax Number | 5177879680 |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 5601001243 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3235 E MICHIGAN AVE |
| City | JACKSON |
| State | MI |
| Zip Code | 49202-3971 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801163316 | Karen Van Eck | Nurse Practitioner | 3235 E Michigan Ave, Jackson, MI 49202-3971 | 2011-11-29 |
| 1437385382 | Shana A Ageloff-kupetz | Family Medicine | 3235 E Michigan Ave, Jackson, MI 49202-3971 | 2009-06-05 |
| 1770746943 | Joel David Miller | Family Medicine | 3235 E Michigan Ave, Jackson, MI 49202-3971 | 2008-07-08 |
| 1548489925 | Cascades Orthopedic Rehabilitation Services | Physical Therapist | 3235 E Michigan Ave, Jackson, MI 49202-3971 | 2007-04-24 |
| 1770613770 | Larry E Jennings Md PC | Family Medicine | 3235 E Michigan Ave, Jackson, MI 49202-3971 | 2007-03-07 |
| 1669554382 | Balasubramaniyam Pisupati | Rehabilitation Practitioner | 3235 E Michigan Ave, Jackson, MI 49202-3971 | 2006-10-20 |
| 1497844120 | Tariq Kutob | Family Medicine | 3235 E Michigan Ave, Jackson, MI 49202-3971 | 2006-10-12 |
| 1629179171 | Larry D Farr | Family Medicine | 3235 E Michigan Ave, Jackson, MI 49202-3971 | 2006-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821590316 | Leslie Dominique Barroso | Social Worker | 834 Kennedy St, Jackson, MI 49202 | 2018-03-01 |
| 1073011136 | Nicole Szarek | Social Worker | 1200 N. West Ave, Jackson, MI 49202 | 2018-01-24 |
| 1598299430 | Cedric Griffin | Behavior Technician | 950 W. Monroe St, Jackson, MI 49202 | 2017-04-18 |
| 1285081612 | Patricia Decker | Psychologist | 950 West Monroe, Suite 500, Jackson, MI 49202 | 2016-05-16 |
| 1619344314 | Erica Ries | Social Worker | 1200 N West Ave Ste 800, Jackson, MI 49202 | 2015-08-28 |
| 1184007189 | Sarah Johnson | Behavioral Analyst | 818 Winifred St, Jackson, MI 49202 | 2015-07-08 |
| 1871971697 | Scott A Watterson Dds, Pllc | Dentist | 1030 Laurence Ave, Suite 3, Jackson, MI 49202 | 2015-05-13 |
| 1043608680 | Brenda Beverly | Counselor | 1190 West, 1190 West Suite 812, Jackson, MI 49202 | 2015-01-06 |
| 1295091593 | Natalie Ann Kember | Social Worker | 1206 Clinton, Jackson, MI 49202 | 2012-04-11 |
| 1912218728 | Tina Marie Pierce | Respite Care | 225 N Wisner St, Jakson, MI 49202 | 2010-06-25 |
| Find all providers in zip 49202 | ||||
| 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 |
|---|---|---|---|---|
| 1942834494 | Emily Amburn | Physician Assistant | 2968 N Highland Ave, Jackson, TN 38305-3409 | 2020-02-24 |
| 1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
| 1972161891 | Allison Taylor | Physician Assistant | 1850 Chadwick Drive, Suite 1427, North Tower, 4 West, Jackson, MS 39204-3404 | 2019-06-05 |
| 1306302328 | Chloe A Goldfarb | Physician Assistant | 21 Shoal Rd, Jackson, NJ 08527-4025 | 2019-02-14 |
| 1447722558 | Casey James Elliott | Physician Assistant | 747 Oakwood St, Jackson, MS 39202-1121 | 2018-12-31 |
| 1700372109 | Chad Zawacki | Physician Assistant | 147 North Star Drive, Jackson, TN 38305 | 2018-07-09 |
| 1982194551 | Samantha Lynn Denoville | Physician Assistant | 1 Kensington Ct, Jackson, NJ 08527-1292 | 2018-05-18 |
| 1104320308 | Dalton Glenn Weaver | Physician Assistant | 708 N Highland Ave, Jackson, TN 38301-4829 | 2018-03-21 |
| 1336669258 | Whitney J Peterson | Physician Assistant | 501 Marshall St Ste 301, Jackson, MS 39202-1687 | 2017-06-21 |
| 1922541093 | Jacob Carpenter | Physician Assistant | 2497 N West St, Jackson, MS 39216-4409 | 2016-11-22 |
| 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.