MS. CAROL A. JEROSIMICH (NPI# 1811996291) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811996291 |
| Entity Type | Individual |
| Full Name | MS. CAROL A. JEROSIMICH |
| Credential | PA-C |
| Practice Address |
170 Jennifer Rd Ste 240 Annapolis MD 21401-7995 |
| Mailing Address |
170 Jennifer Rd Ste 240 Annapolis MD 21401-7995 |
| Practice Telephone | 4105719000 |
| Practice Fax Number | 4102661507 |
| Mailing Telephone | 4105719000 |
| Mailing Fax Number | 4102661507 |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2020-10-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
C0001915 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
C0001915 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FEDERAL WORKMANS COMP | 487760200 | 01 |
| Street Address |
170 JENNIFER RD STE 240 |
| City | ANNAPOLIS |
| State | MD |
| Zip Code | 21401-7995 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245535749 | Kimberly Marie Fern | Physician Assistant | 170 Jennifer Rd Ste 240, Annapolis, MD 21401-7995 | 2011-01-14 |
| 1215194840 | Brian S Kahan Do Pa | Physical Medicine & Rehabilitation | 170 Jennifer Rd Ste 240, Annapolis, MD 21401-7995 | 2008-05-21 |
| 1629240122 | Donna L Jasper | Physical Medicine & Rehabilitation | 170 Jennifer Rd Ste 240, Annapolis, MD 21401-7995 | 2008-03-25 |
| 1740210814 | Brian Scot Kahan | Physical Medicine & Rehabilitation | 170 Jennifer Rd Ste 240, Annapolis, MD 21401-7995 | 2006-07-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497377154 | Michael Khorsandi | Student in an Organized Health Care Education/Training Program | 2001 Medical Parkway, Clatanoff Pavillon, Gmw Office, Annapolis, MD 21401 | 2020-05-15 |
| 1275172033 | Katrice N Nelson | Massage Therapist | Wellsview Cottage Center, 613 Ridgely Avenue, Annapolis, MD 21401 | 2019-12-27 |
| 1548803521 | Victoria Reimnitz | Behavioral Analyst | 2028 Indusrtrial Dr, Ste B&c, Annapolis, MD 21401 | 2019-10-23 |
| 1700438140 | Emily Megan Burke | Nurse Practitioner | 200 Forbes St Annapolis, Md 21401, Suite 200, Annapolis, MD 21401 | 2019-07-16 |
| 1316504848 | Sherina Maryam Shamsa | Counselor | 1830 Forest Drive, Suite H-2, Annapolis, MD 21401 | 2019-05-21 |
| 1497225288 | Jerilyn Deitch | Speech-Language Pathologist | Anne Arundel County Public Schools, 2644 Riva Rd, Annapolis, MD 21401 | 2018-12-05 |
| 1487124038 | Lucinda W Mimms | Speech-Language Pathologist | 2644 Riva Rd., Annapolis, MD 21401 | 2018-11-27 |
| 1487145496 | Michelle Baudean | Behavior Technician | 1919 West St Ste 201, Annapolis, MD 21401 | 2018-05-24 |
| 1730678954 | Stephanie Ruth Streb | Registered Nurse | 130 Admiral Cochrane Dr Ste 103, Annapolis, MD 21401 | 2018-05-02 |
| 1780183947 | Annapolis Sleep Center LLC | Clinic/Center | 2451 Riva Rd, Annapolis, MD 21401 | 2018-02-02 |
| Find all providers in zip 21401 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407107675 | Carl Fredrick Oltman Sr. | Physician Assistant | 1003 Tyler Ave, Annapolis, MD 21403-1909 | 2012-09-27 |
| 1518277698 | Uwe Reichmann | Physician Assistant | 129 Lubrano Dr Ste 200, Annapolis, MD 21401-7567 | 2010-10-07 |
| 1639408644 | William E Burke | Physician Assistant | 3205 Chrisland Dr, Annapolis, MD 21403-4351 | 2009-12-22 |
| 1568545515 | James F Heins Jr. | Physician Assistant | 2002 Medical Pkwy Ste 630, Annapolis, MD 21401-3059 | 2006-10-23 |
| 1568907947 | Michelle Arey | Physician Assistant | 2002 Medical Parkway, Suite 500, Annapolis, MD 21401-3046 | 2016-12-21 |
| 1306238308 | Ashlyn Nicole Yannitello | Physician Assistant | 2001 Medical Pkwy, Annapolis, MD 21401-3773 | 2015-02-27 |
| 1942606462 | Sara Makrinos | Physician Assistant | 116 Defense Hwy, Suite 403, Annapolis, MD 21401-7027 | 2014-11-11 |
| 1972949543 | Melissa Nicole Corbin | Physician Assistant | 2448 Holly Ave, Suite 101, Annapolis, MD 21401-3148 | 2013-05-22 |
| 1447500707 | Michael-anne Ashford | Physician Assistant | 2002 Medical Pkwy, Ste 500, Annapolis, MD 21401-3046 | 2012-09-13 |
| 1154613966 | Angela Marie Redpath | Physician Assistant | 2002 Medical Pkwy, Suite 230, Annapolis, MD 21401-3046 | 2011-05-11 |
| Find all providers in ANNAPOLIS | ||||
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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.