DR. JAY W EASTMAN (NPI# 1730172925) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730172925 |
| Entity Type | Individual |
| Full Name | DR. JAY W EASTMAN |
| Credential | M.D. |
| Practice Address |
30795 23 Mile Rd Ste 202 Chesterfield MI 48047-5721 |
| Practice Telephone | 5864211740 |
| Practice Fax Number | 5864211744 |
| Mailing Telephone | 5864211740 |
| Mailing Fax Number | 5864211744 |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2020-06-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | JE031896 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CARE NETWORK | P41188 | 01 |
| MI | BLUE CROSS AND BLUE SHIEL | 350F314450 | 01 |
| MI | 4324769 | 05 | |
| MI | AETNA | 4332911 | 01 |
| Street Address |
30795 23 MILE RD STE 202 |
| City | CHESTERFIELD |
| State | MI |
| Zip Code | 48047-5721 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336798339 | Sara Lynsey Flanigan | Nurse Practitioner | 30795 23 Mile Rd Ste 202, Chesterfield, MI 48047-5721 | 2019-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174122345 | Allison Johnston Lpc | Community/Behavioral Health | 51500 Birch St. Suite C, New Baltimore, MI 48047 | 2020-10-20 |
| 1184289050 | Emily Virginia Barc | Speech-Language Pathologist | 50522 Elsey St, New Baltimore, MI 48047 | 2019-05-07 |
| 1629562665 | In Your Home Senior Assistance LLC | In Home Supportive Care | 33813 Bayview Drive, Chesterfield, MI 48047 | 2018-06-21 |
| 1669978805 | Tiffany Nicole Bankhead | Nurse's Aide | 35859 Cranbrook Ct., New Baltimore, MI 48047 | 2018-04-05 |
| 1295246031 | Mary-devon Leigh Bement | Social Worker | Grace Counseling, 23 Mile Rd., Chesterfield, MI 48047 | 2017-10-19 |
| 1780107706 | Willow of Wonder Child & Family Therapy Pllc | Community/Behavioral Health | 51500 Birch St Unit C, New Baltimore, MI 48047 | 2017-07-21 |
| 1760903082 | Jason Aaron Johnson | Massage Therapist | 28390 Gamble Road, Chesterfield, MI 48047 | 2017-06-28 |
| 1699226431 | Aaron Curtis Teutsch | Counselor | 35031 23 Mile Rd., New Baltimore, MI 48047 | 2016-10-17 |
| 1285009506 | Adelle Lenhausen | Dental Hygienist | 36500 Front St, New Baltimore, MI 48047 | 2015-12-11 |
| 1528441359 | Elaine Genevieve Grant | Podiatrist | 32743 23 Mile Rd Ste 110, Chesterfield, MI 48047 | 2015-06-29 |
| Find all providers in zip 48047 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154550630 | Kora Nicole Felsch | Pediatrics | 226 S Woods Mill Rd 32w, Chesterfield, MO 63017 | 2009-07-06 |
| 1740491141 | Kathryn Kerr Wade | Pediatrics | 13001 N Outer 40 Rd Ste 310, Ste 310, Chesterfield, MO 63017-5941 | 2007-05-25 |
| 1265656193 | Rosita Justo Guzon | Pediatrics | 1343 Conway Oaks Dr, Chesterfield, MO 63017-1960 | 2007-04-12 |
| 1164594883 | Santosh Gupta | Pediatrics | 16216 Baxter Road Suite 299, Chesterfield, MO 63017 | 2006-11-15 |
| 1073603189 | Robert James Profumo | Pediatrics | 1308 Westchester Manor Ln, Chesterfield, MO 63005-4355 | 2006-10-13 |
| 1215046263 | Julia M Mayer | Pediatrics | 226 S Woods Mill Rd Ste 32w, Chesterfield, MO 63017-3442 | 2006-08-30 |
| 1053351338 | Mohamad Al-hosni | Pediatrics | 14443 White Birch Valley Ln, Chesterfield, MO 63017-2415 | 2006-06-07 |
| 1104891274 | Anna P Huger | Pediatrics | 13001 N Outer 40 Rd Ste 330, Chesterfield, MO 63017-5941 | 2006-02-21 |
| 1154302131 | David E Hartenbach | Pediatrics | 13001 N Outer 40 Rd Ste 320, Chesterfield, MO 63017-5941 | 2005-11-08 |
| 1083601819 | Janet G Mueller | Pediatrics | 13001 N Outer 40 Rd, Ste 340, Chesterfield, MO 63017-5941 | 2005-10-06 |
| Find all providers in CHESTERFIELD | ||||
| City | CHESTERFIELD |
| Zip Code | 48047 |
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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.