MR. GREGORY P MINDOCK (NPI# 1790747665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790747665 |
| Entity Type | Individual |
| Full Name | MR. GREGORY P MINDOCK |
| Credential | PA-C |
| Practice Address |
8906 M 89 Richland MI 49083 |
| Mailing Address |
5943 Stadium Dr Ste 1 Kalamazoo MI 49009-3016 |
| Practice Telephone | 2692867130 |
| Practice Fax Number | 2692867131 |
| Mailing Telephone | 2695522836 |
| Mailing Fax Number | 2695522964 |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2020-10-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 5601001086 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8450 N 32nd St, Richland, MI 490839418 | 2692262500 |
| Street Address |
8906 M 89 |
| City | RICHLAND |
| State | MI |
| Zip Code | 49083 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316230865 | Ashley Elizabeth Diehl | Pediatrics | 8906 M 89, Richland, MI 49083 | 2011-05-17 |
| 1235421223 | Rebecca Anne Runge | Family Medicine | 8906 M 89, Richland, MI 49083 | 2011-05-09 |
| 1811286966 | Evan House Pelc | Pediatrics | 8906 M 89, Richland, MI 49083 | 2011-03-29 |
| 1205021037 | Sarah Marie Jennings | Physician Assistant | 8906 M 89, Richland, MI 49083 | 2007-09-14 |
| 1386848182 | Aimee E Simpson | Pediatrics | 8906 M 89, Richland, MI 49083 | 2007-06-14 |
| 1447360433 | Sandra Dejong | Nurse Practitioner | 8906 M 89, Richland, MI 49083 | 2006-08-30 |
| 1811005184 | Saadia Rahman | Pediatrics | 8906 M 89, Richland, MI 49083-9540 | 2006-08-28 |
| 1790892933 | Sharon Hanley | Nurse Practitioner | 8906 M 89, Richland, MI 49083 | 2006-08-24 |
| 1457388449 | Kurt P Helgerson | Family Medicine | 8906 M 89, Richland, MI 49083 | 2006-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548638919 | Amy Louise Mauro | Specialist/Technologist | 515 S Gull Lake Dr, Richland, MI 49083 | 2015-09-02 |
| 1295085181 | Select Orthopedic Supply | Prosthetic/Orthotic Supplier | 8589 Gull Rd, Ste 2, Richland, MI 49083 | 2012-09-18 |
| 1093016743 | Cheryl Diahnn Austenfeld | Counselor | 2323 Gull Road, Richland, MI 49083 | 2010-11-11 |
| 1790920619 | Comprehensive Psychological and Assessment Services, LLC | Counselor | 10359 M-89, Suite A, Richland, MI 49083 | 2008-12-05 |
| 1518132695 | Richland Chiropractic, PC | Chiropractor | 9800 M 89, Suite 9801, Richland, MI 49083 | 2008-04-29 |
| 1235266586 | Kathryn Joy Zimont | Pharmacist | 8900 Gull Road, Richland, MI 49083 | 2007-02-27 |
| 1073553327 | Richland Podiatry PC | Podiatrist | 8992 E D Ave, Richland, MI 49083 | 2006-06-07 |
| 1023003340 | Lisa Kimberly Largo-marsh | Psychologist | 8799 Gull Road, Suite 1, Richland, MI 49083 | 2005-09-13 |
| 1053739060 | Breanna Cleasby | Chiropractor | 9801 M 89, Richland, MI 49083 | 2014-04-07 |
| 1245307149 | Ann Causey Perra | Counselor | 103 S Fourth St, Sturgis, MI 49083 | 2006-11-29 |
| Find all providers in zip 49083 | ||||
| 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 |
|---|---|---|---|---|
| 1720698814 | Jayven Sadae Heilman-moore | Physician Assistant | 2847 Riverbend Dr, Richland, WA 99354-2202 | 2020-08-04 |
| 1467910265 | Sydney Cejka | Physician Assistant | 2148 Sheridan Pl, Richland, WA 99352-8440 | 2019-03-11 |
| 1891277448 | Tyler Andrew Burgett | Physician Assistant | 1015 Marshall Ave, Richland, WA 99354 | 2018-08-30 |
| 1982122578 | Merissa Yvonne Stoops | Physician Assistant | 780 Swift Blvd Ste 101, Richland, WA 99352-3545 | 2017-09-02 |
| 1821403320 | Precious Alexandra Ravina Stone | Physician Assistant | 1100 Goethals Dr Ste B, Richland, WA 99352-3301 | 2014-06-24 |
| 1255762647 | Daric Craven | Physician Assistant | 2435 Stevens Center Pl # Ms 10-a, Richland, WA 99354-1874 | 2013-12-10 |
| 1356616163 | Marissa Ann Parsons | Physician Assistant | 560 Gage Blvd Suite 260, Kadlec Clinic South Richland Primary Care, Richland, WA 99352 | 2012-03-12 |
| 1275838385 | Joel Quiroz | Physician Assistant | 560 Gage Blvd Suite 206, Richland, WA 99352 | 2011-01-20 |
| 1437309267 | Matthew A. Huwe | Physician Assistant | 780 Swift Blvd Ste 301, Richland, WA 99352 | 2008-09-29 |
| 1396760476 | David Douglas | Physician Assistant | 904 S Pine St, Richland, MO 65556-7393 | 2006-07-12 |
| Find all providers in RICHLAND | ||||
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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.