JACK GUILLERMO SIBAL (NPI# 1962482042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962482042 |
| Entity Type | Individual |
| Full Name | JACK GUILLERMO SIBAL |
| Credential | PA-C |
| Practice Address |
4940 Hamrick Rd Central Point OR 97502-3072 |
| Mailing Address |
3617 S Pacific Hwy Medford OR 97501-8957 |
| Practice Telephone | 5416903600 |
| Practice Fax Number | 5416643735 |
| Mailing Telephone | 5415356239 |
| Mailing Fax Number | 5415121026 |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA184052 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
14456 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1001 S. Seaside Ave; Bldg 23, Isc San Pedro, San Pedro, CA 90731 | 3107327500 | 3107327519 |
| Street Address |
4940 HAMRICK RD |
| City | CENTRAL POINT |
| State | OR |
| Zip Code | 97502-3072 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760038665 | Sara J Yalon | Registered Nurse | 4940 Hamrick Rd, Central Point, OR 97502-3072 | 2019-08-15 |
| 1548611353 | Charles Shepherd | Registered Nurse | 4940 Hamrick Rd, Central Point, OR 97502-3072 | 2016-06-23 |
| 1235592742 | Rosaura Reyes-zepeda | Dental Hygienist | 4940 Hamrick Rd, Central Point, OR 97502-3072 | 2016-04-01 |
| 1558757997 | Kristopher Azevedo | Family Medicine | 4940 Hamrick Rd, Central Point, OR 97502-3072 | 2015-04-13 |
| 1437568169 | Tyler J Wilson | Dentist | 4940 Hamrick Rd, Central Point, OR 97502-3072 | 2014-08-06 |
| 1013347020 | Daniela Diaz | Dentist | 4940 Hamrick Rd, Central Point, OR 97502-3072 | 2013-11-13 |
| 1033490784 | Erin M Schorran | Nurse Practitioner | 4940 Hamrick Rd, Sn-adm, Central Point, OR 97502-3072 | 2011-09-07 |
| 1750661062 | Rachel B Schultz | Dentist | 4940 Hamrick Rd, Central Point, OR 97502-3072 | 2011-08-18 |
| 1639406333 | Elizabeth Banowetz | Family Medicine | 4940 Hamrick Rd, Central Point, OR 97502-3072 | 2009-11-17 |
| 1386650398 | Kelli Ann Lafleur | Nurse Practitioner | 4940 Hamrick Rd, Central Point, OR 97502-3072 | 2006-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013459734 | Rebuilding Together Rogue Valley | Home Health | 421 Stone Pointe Drive, Central Point, OR 97502 | 2016-11-11 |
| 1801262431 | Kathleen Marie Vandevender | Behavioral Analyst | 153 Wind Song Drive, Central Point, OR 97502 | 2015-08-18 |
| 1356735112 | Nikole Mcewen | Behavioral Analyst | 2030 Taylor Rd, Central Point, OR 97502 | 2015-03-19 |
| 1619368636 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 200 W Pine St, Central Point, OR 97502 | 2015-02-12 |
| 1124429360 | Sarah Jean North | Massage Therapist | 2463 Saint James Way, Central Point, OR 97502 | 2014-09-08 |
| 1972928034 | Jennifer Joe-anne Marks | Registered Nurse | 312 Oak St. Ste #205, Central Point, OR 97502 | 2014-02-26 |
| 1578991527 | Lawrence Gerald Whittington | Behavioral Analyst | 6340 Honey Tree Ln., Central Point, OR 97502 | 2013-10-29 |
| 1093141582 | Samuel Joseph Hicks | Behavioral Analyst | 4434 Corey Road, Central Point, OR 97502 | 2013-09-17 |
| 1598191074 | Kathie Ellen Moss | Behavioral Analyst | 5315 Teresa Way, Central Point, OR 97502 | 2013-09-17 |
| 1831525336 | Becky Kay Lunsford | Behavioral Analyst | 640 S. 2nd Street, Family Solutions, Central Point, OR 97502 | 2013-09-17 |
| Find all providers in zip 97502 | ||||
| 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 |
|---|---|---|---|---|
| 1023481413 | Amy N Oppen | Physician Assistant | 870 S Front St Ste 20, Central Point, OR 97502-2779 | 2015-11-05 |
| 1811463250 | Caitlin M Zimmerman | Physician Assistant | 870 S Front St Ste 200, Central Point, OR 97502-2779 | 2018-10-23 |
| 1467933481 | Jason W Gorsegner | Physician Assistant | 870 S Front St Ste 200, Central Point, OR 97502-2779 | 2018-08-27 |
| 1356709026 | Kristen E Munks | Physician Assistant | 870 S Front St, Ste 200, Central Point, OR 97502-2779 | 2016-02-09 |
| 1336236744 | Tatyana M Wright | Physician Assistant | 870 S Front St, Suite 200, Central Point, OR 97502-2779 | 2006-10-06 |
| 1417927922 | Elizabeth Ann Rugg | Physician Assistant | 4940 Hamrick Rd, Central Point, OR 97502-3072 | 2006-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801495569 | Lynsie Wolfe | Physician Assistant | 3000 Bryant Williams Dr Ste 200, Klamath Falls, OR 97601-1140 | 2020-10-22 |
| 1548867856 | Megan Elaine Stewart | Physician Assistant | 3773 Pinetop Dr, Medford, OR 97504-9638 | 2020-10-08 |
| 1639786411 | Bridget Meade-sentosun | Physician Assistant | 2599 Ne Overlook Dr Apt 815, Hillsboro, OR 97124-7613 | 2020-09-25 |
| 1518570738 | Samantha Larelle Williamson | Physician Assistant | 1551 2nd St, Umatilla, OR 97882-9707 | 2020-08-27 |
| 1356951891 | Eric James Humphrey | Physician Assistant | 1055 Ne Creeksedge Dr, Hillsboro, OR 97124-1316 | 2020-08-07 |
| 1427676493 | Lindsey Louise Peterson | Physician Assistant | 3505 N Williams Ave, Portland, OR 97227-1437 | 2020-07-07 |
| 1871110361 | Dana Sierra Jackson | Physician Assistant | 370 Ne Garner St, Prineville, OR 97754-2039 | 2020-06-30 |
| 1518584036 | Abigail Nichole Dumont | Physician Assistant | 6064 Sw 30th Ave, Portland, OR 97239-1018 | 2020-06-30 |
| 1831712280 | Joshua Sprague | Physician Assistant | 6501 Ne Cherry Dr Apt 1112, Hillsboro, OR 97124-7711 | 2020-05-20 |
| 1376165134 | Emily Axelrod | Physician Assistant | 19648 Wildwood Dr, West Linn, OR 97068-2210 | 2020-05-14 |
| Find all providers with the same taxonomy | ||||
| City | CENTRAL POINT |
| Zip Code | 97502 |
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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.