JACOB D SILLAMAN (NPI# 1902208309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902208309 |
| Entity Type | Individual |
| Full Name | JACOB D SILLAMAN |
| Credential | PA |
| Practice Address |
1380 E Stroop Rd Kettering OH 45429-4926 |
| Mailing Address |
1 Prestige Pl Suite 550 Miamisburg OH 45342-3794 |
| Practice Telephone | 9372944356 |
| Practice Fax Number | 9372972381 |
| Mailing Telephone | 9377522305 |
| Mailing Fax Number | 9375227513 |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2014-12-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
50004125 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0110639 | 05 |
| Street Address |
1380 E STROOP RD |
| City | KETTERING |
| State | OH |
| Zip Code | 45429-4926 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063494086 | Ajay Reddivari | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2005-11-16 |
| 1821342320 | Sarah Christine Gibble | Physician Assistant | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2012-11-05 |
| 1013288166 | Amanda Yun Anania | Physician Assistant | 1380 E Stroop Rd, Kettering, OH 45429 | 2012-01-21 |
| 1396049011 | Ryan Stewart Clark | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2011-01-10 |
| 1144532409 | Mohammed O Ali | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2010-07-02 |
| 1720106685 | Nathaniel Joseph Dittoe | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2007-03-27 |
| 1750432811 | Cardiology South | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2007-01-16 |
| 1306864608 | Mark W Moronell | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429 | 2006-07-17 |
| 1669456943 | Robert Woodrow Kiefaber | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2005-12-01 |
| 1023091501 | Calvert Raymond Busch | Internal Medicine | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2005-11-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821576414 | Lauren Danielle Sivley | Nurse Practitioner | 3535 Sourthern Boulevard, Kettering, OH 45429 | 2018-08-06 |
| 1114446127 | Louai Al-samkari | Chiropractor | 1441 E. Stroop Rd., Kettering, OH 45429 | 2017-09-12 |
| 1407373756 | Benjamin Edward Adkins | Specialist/Technologist | 4116 Vinita Dr., Kettering, OH 45429 | 2017-08-28 |
| 1972036341 | James Kim | Student in an Organized Health Care Education/Training Program | 3535 Southern Boulevard, Kettering, OH 45429 | 2017-04-04 |
| 1023549847 | Adrienne Krysiak | Emergency Medicine | 3525 Southern Boulevard, Kettering, OH 45429 | 2017-03-23 |
| 1386021889 | Cassandra Mckoy | Counselor | 529 East Stroop Road, Kettering, OH 45429 | 2015-05-04 |
| 1417343088 | Candace Benoit | Obstetrics & Gynecology | 3533 Southern Blvd Ste 4600, Dayton, OH 45429 | 2015-04-10 |
| 1275933574 | Lee Schwieterman | Nurse Practitioner | 3535 Southern Blvd., 1 East, Kettering, OH 45429 | 2014-08-25 |
| 1497161947 | Robert Jonathon Fresch Jr. | Obstetrics & Gynecology | 3533 Southern Blvd Ste 3750, Kettering, OH 45429 | 2014-07-05 |
| 1821349812 | Lucas Brewer | Counselor | 1524 E Stroop Rd Ste 300, Kettering, OH 45429 | 2012-10-01 |
| Find all providers in zip 45429 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538113295 | Mary C Dibenedetto | Physician Assistant | 3075 Governors Place Blvd Ste 120, Kettering, OH 45409-1332 | 2006-05-19 |
| 1578173878 | Connor Michael-lehman Wolfe | Physician Assistant | 3533 Southern Blvd Ste 2100, Kettering, OH 45429-1267 | 2020-08-03 |
| 1922631761 | Michael Patrick Lorey | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-02-20 |
| 1487137691 | William E Carrigg | Physician Assistant | 3737 Southern Blvd Ste 2100, Kettering, OH 45429-1285 | 2018-09-13 |
| 1457754236 | Sarah-jane E. Mcpherson | Physician Assistant | 3700 Southern Blvd Ste 401, Kettering, OH 45429-1226 | 2014-10-07 |
| 1821342320 | Sarah Christine Gibble | Physician Assistant | 1380 E Stroop Rd, Kettering, OH 45429-4926 | 2012-11-05 |
| 1730451733 | Nathanael Paul Mcniel | Physician Assistant | 3533 Southern Blvd, Ste 3000, Kettering, OH 45429-1280 | 2012-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023618428 | Stephanie Ann Keener | Physician Assistant | 7774 Hythe Cir, Centerville, OH 45459-8705 | 2020-10-27 |
| 1174122600 | Maria Drankov Lane | Physician Assistant | 1806 Muskegon Dr, Cincinnati, OH 45255-2635 | 2020-10-26 |
| 1326647512 | Junell Rutledge | Physician Assistant | 644 High St, Youngstown, OH 44502-1562 | 2020-10-20 |
| 1699372383 | Samantha Kibler | Physician Assistant | 7337 Caritas Cir Nw Ste 150, Massillon, OH 44646-9128 | 2020-10-06 |
| 1982218186 | Morgan Holmes | Physician Assistant | 65 Community Rd Ste F, Tallmadge, OH 44278-2358 | 2020-09-04 |
| 1902456023 | Kara Meyer | Physician Assistant | 2417 Derbyshire Ct, Cleveland Heights, OH 44106-2778 | 2019-09-19 |
| 1679122394 | Mariah Bower | Physician Assistant | 2725 Hampshire Rd Apt 3, Cleveland, OH 44106-2570 | 2019-09-05 |
| 1457908014 | Kristen Fairchild | Physician Assistant | 4235 Secor Rd Bldg 2, Toledo, OH 43623-4231 | 2019-08-19 |
| 1811549462 | Abigail Malsch | Physician Assistant | 2376 Fenwood Rd, University Heights, OH 44118-3804 | 2019-07-14 |
| 1164087466 | Jessica Lee Schulte | Physician Assistant | 1110 West Main Cross St., Findlay, OH 45840-2423 | 2019-05-02 |
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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.