NICHOLAS R. KLOCK (NPI# 1629420435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629420435 |
| Entity Type | Individual |
| Full Name | NICHOLAS R. KLOCK |
| Credential | PA-C |
| Practice Address |
4755 Ogletown Stanton Road Suite 5a43 Newark DE 19718-2200 |
| Mailing Address |
200 Hygeia Drive Cchs Physician Contracting, Suite 2300 Newark DE 19713-2049 |
| Practice Telephone | 3026230188 |
| Practice Fax Number | 3027335640 |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2017-08-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
C5-0001149 | DE | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4755 OGLETOWN STANTON ROAD SUITE 5A43 |
| City | NEWARK |
| State | DE |
| Zip Code | 19718-2200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851397392 | Leonard I Japko | Pathology | 4755 Ogletown Stanton Road, Newark, DE 19718-0001 | 2005-06-21 |
| 1366901365 | Meghan P Ericksen | Registered Nurse | 4755 Ogletown Stanton Road, Suite 1070, Newark, DE 19718-2200 | 2019-03-19 |
| 1144712613 | Hannah Betters | Physician Assistant | 4755 Ogletown Stanton Road, Suite 2670, Christiana Hospital Dept of Surgery, Newark, DE 19718-2200 | 2018-05-31 |
| 1699291328 | Joy Zaccaria | Physician Assistant | 4755 Ogletown Stanton Road, Suite 5a43, Newark, DE 19718-2200 | 2017-08-15 |
| 1023548914 | Maureen Ann Moffett | Clinical Nurse Specialist | 4755 Ogletown Stanton Road, Neonatal Intensive Care Unit, Newark, DE 19718 | 2017-06-14 |
| 1386182186 | Ashley Boller | Physician Assistant | 4755 Ogletown Stanton Road, Suite 2e99, Newark, DE 19718-2200 | 2017-02-01 |
| 1205387016 | Sonya Modi | Physician Assistant | 4755 Ogletown Stanton Road, Suite 5a43, Newark, DE 19718-2200 | 2016-10-17 |
| 1942681614 | Dana Chanes Manuel | Internal Medicine | 4755 Ogletown Stanton Road, Suite 5a43, Newark, DE 19718-2200 | 2015-06-17 |
| 1821477324 | Thomas Keith Sheehan II | Internal Medicine | 4755 Ogletown Stanton Road, Suite 5a43, Newark, DE 19718-2200 | 2015-05-29 |
| 1780061754 | James Luther Pugh Jr. | Registered Nurse | 4755 Ogletown Stanton Road, Newark, DE 19718-1320 | 2015-04-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679026272 | Vikashsingh Parshin Rambhujun | Student in an Organized Health Care Education/Training Program | 4755 Ogletown-stanton Road, Suite 2875, Newark, DE 19718 | 2016-07-29 |
| 1730536053 | David Nathan Levine | Student in an Organized Health Care Education/Training Program | 4755 Ogletown-stanton Rd, Christiana Health Care, Newark, DE 19718 | 2016-05-17 |
| 1831570332 | Waqas Abid | Student in an Organized Health Care Education/Training Program | 4755 Ogletown-stanton Rd, S-le45, Newark, DE 19718 | 2015-06-11 |
| 1366886368 | Amanda J Taylor | Family Medicine | 4755 Ogletown Stanton Rd Ste 6e34, Newark, DE 19718 | 2013-04-20 |
| 1114360872 | Kalpana Suresh | Surgery | 4755 Ogletown-stanton Rd., Newark, DE 19718 | 2013-04-12 |
| 1568580769 | Ember L. Crevar | Pediatrics | 4755 Ogletown Stanton Rd., Christiana Care Hospital - Dept. of Pediatrics, Newark, DE 19718 | 2007-03-26 |
| 1336283803 | Kevin William Smallwood | Physician Assistant | 4755 Ogletown-stanton Dr, Suite 1e50, Newark, DE 19718 | 2007-02-17 |
| 1023066404 | Samuel G Putnam IIi | Radiology | 4755 Ogletown Santon Road, Suite 1e20, Newark, DE 19718 | 2006-05-05 |
| 1053374181 | Hung Quang Dam | Nuclear Medicine | Nuclear Medicine, 4755 Ogletown-stanton Rd, Newark, DE 19718 | 2006-04-10 |
| 1346211018 | Robert Flinn | Internal Medicine | 4655 Ogletown-stanton Road, Suite 5343, Newark, DE 19718 | 2006-01-30 |
| Find all providers in zip 19718 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457702177 | Jacinta Hollinger | Physician Assistant | C78-80 Omega Dr, Newark, DE 19713-2076 | 2016-06-23 |
| 1851709877 | Bethany Anne Melo | Physician Assistant | 4755 Ogletown Stanton Rd Fl 3, Newark, DE 19718-2200 | 2014-07-23 |
| 1437442357 | Sherifa P Julien-johnson | Physician Assistant | 238 Mulberry St, Newark, NJ 07102-3528 | 2011-05-25 |
| 1821319997 | Melva M Brown | Physician Assistant | 354 Doremus Ave, Newark, NJ 07105-4882 | 2010-06-11 |
| 1437303302 | Helen Brightman | Physician Assistant | 150 Bergen St # H245, Newark, NJ 07103-2496 | 2008-11-05 |
| 1669657623 | John Stewart Constance | Physician Assistant | Christiana Care Health System Dept of Medicine, 4755 Ogletown-stanton Rd., Newark, DE 19718-0001 | 2008-01-08 |
| 1114935152 | Susan E Matarese | Physician Assistant | 1200 Peoples Plz, Suite 1285, Newark, DE 19702-5701 | 2006-08-04 |
| 1306453766 | Justin Michael Pipoli | Physician Assistant | 4755 Ogletown Stanton Rd, Newark, DE 19718-2200 | 2020-09-29 |
| 1710596895 | Alyssa N Floyd | Physician Assistant | 78 Omega Dr Bldg C, Newark, DE 19713-2064 | 2020-07-24 |
| 1649898834 | Nicholas D Biermann | Physician Assistant | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2020-07-14 |
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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.