MS. JENNIFER CHRISTINE MODESTO (NPI# 1750483244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750483244 |
| Entity Type | Individual |
| Full Name | MS. JENNIFER CHRISTINE MODESTO |
| Credential | B.S., PA-C |
| Practice Address |
33301 Woodward Ave Birmingham MI 48009-0905 |
| Practice Telephone | 2486429111 |
| Practice Fax Number | 2486423905 |
| Mailing Telephone | 2486429111 |
| Enumeration Date | 2006-09-04 |
| Last Update Date | 2011-06-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 5601004881 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AETNA | 7463850 | 01 | |
| MI | MEDICARE RAILROAD | P00349237 | 01 |
| Street Address |
33301 WOODWARD AVE |
| City | BIRMINGHAM |
| State | MI |
| Zip Code | 48009-0905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598730715 | Adam T Gomoll | Physician Assistant | 33301 Woodward Ave, Birmingham, MI 48009-0905 | 2006-02-21 |
| 1225309560 | Rachel M Giampetroni | Physician Assistant | 33301 Woodward Ave, Birmingham, MI 48009-0905 | 2012-01-18 |
| 1578571303 | David V Spurlin, M.d., P.l.l.c. | Dermatology | 33301 Woodward Ave, Birmingham, MI 48009-0905 | 2006-08-04 |
| 1679500573 | David Vincent Spurlin | Dermatology | 33301 Woodward Ave, Birmingham, MI 48009-0905 | 2006-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487183836 | Carolyn Joanna Archer | Dietitian, Registered | 1155 Derby Rd, Apt 3, Birmingham, MI 48009 | 2017-06-08 |
| 1912374695 | Valerie Kim Kaplansky | Counselor | 300 E. Maple Road, 315, Birmingham, MI 48009 | 2015-08-28 |
| 1578956348 | Nancy Jane Naski | Recreation Therapist | 623 Hanna St, Birmingham, MI 48009 | 2015-03-18 |
| 1619370236 | Caitlin Stoltman | Recreation Therapist | 1669 W. Maple Rd., Far, Birmingham, MI 48009 | 2014-09-28 |
| 1295140770 | Lauren Elizabeth Perlin | Obstetrics & Gynecology | 35046 Woodward Ave Ste 100, Birmingham, MI 48009 | 2014-06-24 |
| 1235560764 | Better Life Learning | Community/Behavioral Health | 33717 Woodward Ave #253, Birmingham, MI 48009 | 2013-12-10 |
| 1689949034 | Drs Housecalls PC | Internal Medicine | 298 S. Old Woodward, Birminham, MI 48009 | 2012-03-19 |
| 1689942021 | Brian Connolly Md PC | Psychiatry & Neurology | 189 Townsend, Suite 300, Birmingham, MI 48009 | 2011-12-13 |
| 1619204187 | Dr. Lori PC | Dermatology | 353 South Old Woodward Ave, Birmingham, MI 48009 | 2009-11-04 |
| 1033348453 | Jason Eric Gregory | Music Therapist | 1669 West Maple, Birmingham, MI 48009 | 2009-07-07 |
| Find all providers in zip 48009 | ||||
| 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 |
|---|---|---|---|---|
| 1629679295 | Maltiece O'neal El | Physician Assistant | 1331 14th Ave S Apt 12, Birmingham, AL 35205-5341 | 2020-11-02 |
| 1477164580 | Rebecca Diane Davis | Physician Assistant | 701 S. 19th St, Lhr 112, Birmingham, AL 35233 | 2020-08-12 |
| 1437769981 | Kelsey Marie Robinson | Physician Assistant | 2400 Mahaska Dr, Birmingham, AL 35244-2241 | 2020-08-08 |
| 1508475740 | Stephanie Joseph Gilkey | Physician Assistant | 1505 Pleasant Ct, Birmingham, MI 48009-2909 | 2020-07-23 |
| 1619591922 | Alec Weil | Physician Assistant | 1400 19th St S, Birmingham, AL 35205-4903 | 2020-06-02 |
| 1689293888 | Molly Lynn Miller | Physician Assistant | 619 19th St S Fl 6, Birmingham, AL 35249-1900 | 2020-04-09 |
| 1730712571 | Emily Fallon Wilson | Physician Assistant | 3686 Grandview Pkwy Ste 530, Birmingham, AL 35243-3405 | 2020-02-20 |
| 1538791074 | Caroline Garrison Inge | Physician Assistant | 2700 10th Ave S Ste 505, Birmingham, AL 35205-1250 | 2020-02-11 |
| 1770114274 | Christopher Hopfner | Physician Assistant | 1809 Haynes St, Birmingham, MI 48009-6822 | 2020-02-03 |
| 1821550815 | Rebecca Brajak | Physician Assistant | 48 Medical Park Dr E Ste 150, Birmingham, AL 35235-3456 | 2019-04-01 |
| Find all providers in BIRMINGHAM | ||||
| City | BIRMINGHAM |
| Zip Code | 48009 |
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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.