IRINA SERGEEVNA PETTY (NPI# 1619211463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1619211463 |
Entity Type | Individual |
Full Name | IRINA SERGEEVNA PETTY |
Credential | PA |
Practice Address |
2000 Tamarack Rd Newark OH 43055 |
Practice Telephone | 2205644650 |
Practice Fax Number | 2205644238 |
Mailing Telephone | 2205644650 |
Mailing Fax Number | 2205644238 |
Enumeration Date | 2012-11-17 |
Last Update Date | 2018-04-30 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363A00000X | Physician Assistant | 003613 | OH | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
2000 TAMARACK RD |
City | NEWARK |
State | OH |
Zip Code | 43055 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619976669 | Ilya G Goldenberg | Internal Medicine | 2000 Tamarack Rd, Newark, OH 43055-1183 | 2005-07-20 |
1598204398 | Select Specialty Hospital Zanesville Inc | Hospitalist | 2000 Tamarack Rd, 2nd Floor, Newark, OH 43055-1183 | 2017-02-14 |
1437407269 | Mcn Hospitalist Group LLC | Internal Medicine | 2000 Tamarack Rd, Newark, OH 43055-1183 | 2012-08-28 |
1821276163 | Meritas Medical, Inc | Internal Medicine | 2000 Tamarack Rd, Newark, OH 43055-1183 | 2008-02-08 |
1164627733 | Medical Center of Newark, L.L.C. | General Acute Care Hospital | 2000 Tamarack Rd, Newark, OH 43055-1183 | 2007-06-15 |
1285783860 | S Anne Miller-cohen | Nurse Anesthetist, Certified Registered | 2000 Tamarack Rd, Newark, OH 43055-1183 | 2007-01-10 |
1215093950 | Connie Greene | Nurse Anesthetist, Certified Registered | 2000 Tamarack Rd, Newark, OH 43055-1183 | 2006-12-28 |
1154496503 | Licking Memorial Professional Corp. | General Practice | 2000 Tamarack Rd, Newark, OH 43055 | 2006-11-21 |
1790854933 | Eun K Choe | Anesthesiology | 2000 Tamarack Rd, Newark, OH 43055-1183 | 2006-11-06 |
1154406593 | Betty S. Gebhart | Social Worker | 2000 Tamarack Rd, Newark, OH 43055-1183 | 2006-10-26 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770125585 | Jessica Danielle Dunkle | Case Manager/Care Coordinator | 15 N 3rd Street Suite 300, Newark, OH 43055 | 2019-10-14 |
1558910331 | Diana Cleland | Home Health Aide | 25 Western Rd, Apartment A, Newark, OH 43055 | 2019-09-05 |
1912424789 | Sandra Lou Fraley | Community/Behavioral Health | 15 North 3rd Street, Suite 300, Newark, OH 43055 | 2017-08-23 |
1215450911 | Caitlyn Thella Smith Elkins | Social Worker | 15 N. 3rd St., Newark, OH 43055 | 2017-07-25 |
1992227888 | Sierra Elizabeth Donley | Student in an Organized Health Care Education/Training Program | 140 W Church St, Newark, OH 43055 | 2017-07-12 |
1386170587 | Patricia Louise Fischer | Pharmacist | 1155 North 21rst Street, Newark, OH 43055 | 2017-05-08 |
1689120958 | Bebout Services, LLC | Home Health | 1325 Dayton Road Ne, Newark, OH 43055 | 2016-08-28 |
1750834594 | Laura Smith | Registered Nurse | 1445 West Main Street, Suite B, Newark, OH 43055 | 2016-07-28 |
1164807277 | Frank Kobe | Psychologist | 116 N. 21st Street, Newark, OH 43055 | 2015-07-30 |
1770975898 | Gentle Foot Care, Inc | Podiatrist | 1271 W Main Street, Bldg 1, Newark, OH 43055 | 2015-02-26 |
Find all providers in zip 43055 |
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 |
---|---|---|---|---|
1326647488 | Julia Siyao Yu | Physician Assistant | 541 Oakdale Rd Apt D, Newark, DE 19713-2928 | 2020-10-20 |
1376001990 | Kiley Dale Titus | Physician Assistant | 165 E Union St, Newark, NY 14513-1559 | 2019-03-04 |
1528559457 | Sarah Mun | Physician Assistant | 4755 Ogletown Stanton Rd, Newark, DE 19713 | 2018-05-26 |
1750833646 | Rosalyn Hightower | Physician Assistant | 1213 Churchmans Rd, Newark, DE 19713-2149 | 2016-10-26 |
1013342757 | Leia Lavoie Collins | Physician Assistant | 4735 Ogletown- Stanton Rd Map 2 Suite 1208, Newark, DE 19713-2072 | 2013-09-12 |
1447509179 | Chloe E Dickinson | Physician Assistant | 550 S College Ave Ste 115, Newark, DE 19706-1308 | 2012-09-10 |
1447509591 | Drew Pento | Physician Assistant | 4051 Ogletown Stanton Rd, Newark, DE 19718-0001 | 2012-09-05 |
1568711034 | Jacqueline Pellenbarg | Physician Assistant | 4701 Ogletown Stanton Rd Ste 2100, Newark, DE 19713-7000 | 2012-08-30 |
1912284530 | Ian A Blizzard | Physician Assistant | 2600 Glasgow Ave Ste 124, Newark, DE 19702-4777 | 2011-11-10 |
1043596133 | Victoria Leicht | Physician Assistant | 537 Stanton Christiana Rd Ste 209, Newark, DE 19713-2148 | 2011-11-02 |
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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.