JACOB L. RUNYAN (NPI# 1881022960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881022960 |
| Entity Type | Individual |
| Full Name | JACOB L. RUNYAN |
| Credential | PA-C |
| Practice Address |
305 N 37th St Norfolk NE 68701-3275 |
| Mailing Address |
Po Box 70 Stuart NE 68780-0070 |
| Practice Telephone | 4023704100 |
| Practice Fax Number | 4023704101 |
| Mailing Telephone | 4029243777 |
| Mailing Fax Number | 4029243776 |
| Enumeration Date | 2013-10-28 |
| Last Update Date | 2020-09-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 1775 | NE | Allopathic & Osteopathic Physicians |
| Y | 363A00000X | Physician Assistant | 1775 | NE | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | 5062118 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 101 E South St # 146, Bassett, NE 687145508 | 4026842285 | 4026842299 |
| 110 W 2nd St # 70, Stuart, NE 687801701 | 4029243777 | 4029243776 |
| 305 N 37th St, Norfolk, NE 687013275 | 4023704100 | 4023704101 |
| 418 E 5th St # 403, Atkinson, NE 687134885 | 4029252994 | 4029252996 |
| 913 E Zero St, Ainsworth, NE 692101556 | 4023871900 | 4023870139 |
| Street Address |
305 N 37TH ST |
| City | NORFOLK |
| State | NE |
| Zip Code | 68701-3275 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134112832 | Kari L Galyen | Family Medicine | 305 N 37th St, Norfolk, NE 68701-3275 | 2005-08-26 |
| 1679062681 | Sally Eppenbach | Nurse Practitioner | 305 N 37th St, Norfolk, NE 68701 | 2018-05-04 |
| 1811492986 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 305 N 37th St, Norfolk, NE 68701 | 2018-03-29 |
| 1588164107 | Lindsey Schutte | Physician Assistant | 305 N 37th St, Norfolk, NE 68701-3275 | 2018-02-20 |
| 1508388562 | Sunny Meadow Medical Clinic PC | Family Medicine | 305 N 37th St, Norfolk, NE 68701-3275 | 2017-07-12 |
| 1285082461 | Jonathan Dean Gotschall | Physician Assistant | 305 N 37th St, Norfolk, NE 68701-3275 | 2016-05-29 |
| 1174988448 | Regional West Medical Center | Clinical Medical Laboratory | 305 N 37th St, Norfolk, NE 68701-3275 | 2015-12-30 |
| 1255619003 | Sunny Meadow Medical Clinic PC | Family Medicine | 305 N 37th St, Norfolk, NE 68701-3275 | 2011-07-27 |
| 1487941118 | Kayla Marie Daniels | Physician Assistant | 305 N 37th St, Norfolk, NE 68701-3275 | 2011-07-01 |
| 1346318250 | Andrew J Lear | Physician Assistant | 305 N 37th St, Norfolk, NE 68701-3275 | 2006-11-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700408465 | Women's Empowering Life Line, Inc. | Substance Abuse Rehabilitation Facility | 200 South 13th St, Norfolk, NE 68701 | 2020-05-15 |
| 1093297103 | Nicole Marie Owens | Physician Assistant | 2701 W. Norfolk Ave, Norfolk, NE 68701 | 2018-09-05 |
| 1326535410 | Healing Hands of Nebraska, PC | Otolaryngology | Sunset Plaza, 1700 Market Lane, Suite 410, Norfolk, NE 68701 | 2018-04-16 |
| 1356864995 | Nmg LLC | Family Medicine | 301 North 27th Street Suite 1, Norfolk, NE 68701 | 2017-07-25 |
| 1609396423 | Alison Erin Pfeifer | Physical Therapy Assistant | 1220 W Benjamin Ave #4, Norfolk, NE 68701 | 2017-06-22 |
| 1568996148 | Xanat Naranjo | Registered Nurse | 105 E. Norfolk Ave, Norfolk, NE 68701 | 2017-04-20 |
| 1194259945 | Angela Cornett | Licensed Practical Nurse | 105 E. Norfolk, Norfolk, NE 68701 | 2017-04-19 |
| 1669906400 | Melodie Ann Nielsen | Registered Nurse | 105 East Norfolk Ave, Norfolk, NE 68701 | 2017-04-19 |
| 1528519543 | Women's Empowering Life Line | Substance Abuse Rehabilitation Facility | 910 West Park Avenue, Norfolk, NE 68701 | 2016-10-14 |
| 1174983100 | Brooke Cemper | Nurse Practitioner | 2701 West Norfolk Ave, Norfolk, NE 68701 | 2016-03-03 |
| Find all providers in zip 68701 | ||||
| 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 |
|---|---|---|---|---|
| 1770184434 | Jacob Solomon Morrill | Physician Assistant | 2701 W Norfolk Ave Fl 4, Norfolk, NE 68701-4407 | 2020-11-07 |
| 1558990291 | Ellen Marie Pagliarulo | Physician Assistant | 21 Ridge Rd, Norfolk, MA 02056-1748 | 2020-04-04 |
| 1437785870 | Marissa Knott | Physician Assistant | 7509 Honeysuckle Rd, Norfolk, VA 23518-4514 | 2020-03-17 |
| 1700428349 | Sydney Charmagne Pawsey | Physician Assistant | 601 Pembroke Ave Apt 610, Norfolk, VA 23507-2051 | 2019-10-15 |
| 1831730944 | Brittany Anne Porter | Physician Assistant | 1362 Virgilina Ave, Norfolk, VA 23503-2218 | 2019-10-01 |
| 1437626686 | Kayla Sommers | Physician Assistant | 601 Childrens Ln Fl 2, Norfolk, VA 23507-1910 | 2018-10-25 |
| 1821573593 | Giselle Castaneda De Guzman | Physician Assistant | 400 W Brambleton Ave Ste 104, Norfolk, VA 23510-1151 | 2018-09-28 |
| 1093297103 | Nicole Marie Owens | Physician Assistant | 2701 W. Norfolk Ave, Norfolk, NE 68701 | 2018-09-05 |
| 1265925150 | Emily Burke | Physician Assistant | 171 Kempsville Rd Ste 200, Norfolk, VA 23502-4700 | 2018-06-14 |
| 1124546163 | Jonathan Joseph Daly | Physician Assistant | 171 Kempsville Rd Bldg A2nd, Norfolk, VA 23502-4700 | 2017-08-30 |
| Find all providers in NORFOLK | ||||
Please comment or provide details below to improve the information on JACOB L. RUNYAN.
| 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.