JENNIFER E LEIBOLD (NPI# 1962710103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962710103 |
| Entity Type | Individual |
| Full Name | JENNIFER E LEIBOLD |
| Credential | PA-C |
| Practice Address |
1010 Woodman Dr Dayton OH 45432-1400 |
| Practice Telephone | 9374242215 |
| Practice Fax Number | 9372523700 |
| Mailing Telephone | 9374242215 |
| Mailing Fax Number | 9372521224 |
| Enumeration Date | 2010-09-22 |
| Last Update Date | 2014-10-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 50001562 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
50.001562 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0104799 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558810275 | Jennifer Leibold | Nurse Anesthetist, Certified Registered | 420 S 5th Ave, West Reading, PA 19611-2143 | 2016-09-22 |
| 1750837241 | Jennifer Leibold | Pharmacist | 101 W Market St, Orwigsburg, PA 17961-1807 | 2016-08-25 |
| Street Address |
1010 WOODMAN DR |
| City | DAYTON |
| State | OH |
| Zip Code | 45432-1400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568468320 | Christian Mark Hoffman | Physical Therapist | 1010 Woodman Dr, Dayton, OH 45432-1400 | 2005-06-24 |
| 1265032437 | Caitlin Harpring | Physical Therapist | 1010 Woodman Dr, Dayton, OH 45432-1400 | 2020-10-27 |
| 1811504798 | Christopher Mancuso | Physical Therapist | 1010 Woodman Dr, Dayton, OH 45432-1400 | 2020-09-25 |
| 1932664752 | Heidi M. Schindler | Nurse Practitioner | 1010 Woodman Dr, Dayton, OH 45432-1400 | 2019-02-06 |
| 1144704891 | Jcc, LLC | Clinic/Center | 1010 Woodman Dr, Dayton, OH 45432-1400 | 2018-09-19 |
| 1952804437 | Sherry M Arnold | Nurse Practitioner | 1010 Woodman Dr, Dayton, OH 45432-1400 | 2018-03-12 |
| 1912435629 | Mariah Rae Orr | Physician Assistant | 1010 Woodman Dr, Dayton, OH 45432-1400 | 2017-05-24 |
| 1154867794 | Jacqueline Horne | Nurse Practitioner | 1010 Woodman Dr, Dayton, OH 45432-1400 | 2017-01-06 |
| 1669836904 | Elizabeth Gminski | Nurse Practitioner | 1010 Woodman Dr, Dayton, OH 45432-1400 | 2016-04-13 |
| 1376907105 | Shakirat Adebola Bankole | Nurse Practitioner | 1010 Woodman Dr, Dayton, OH 45432-1400 | 2016-04-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538789284 | Shannon Davis Kaufman | Counselor | National Youth Advocate Program, 1020 Woodman Drive Suite 330, Dayton, OH 45432 | 2020-04-23 |
| 1215480504 | Heather Iaquinta | Registered Nurse | 1430 Linden Ave., Suite 390, Dayton, OH 45432 | 2016-08-03 |
| 1346586682 | Jeffrey Craig Miller | Dentist | 4450 Linden Ave., Dayton, OH 45432 | 2012-12-13 |
| 1194997718 | Paul G Tarlano Dds Inc | Dentist | 3621 Dayton-xenia Rd, Beaver Creek, OH 45432 | 2008-03-25 |
| 1306018981 | Paul Gerald Tarlano | Dentist | 3621 Dayton Xenia Rd, Beavercreek, OH 45432 | 2008-03-24 |
| 1104035377 | Andrew Brody | Occupational Therapy Assistant | 1974 North Fairfield Road, Beavercreek, OH 45432 | 2007-05-22 |
| 1952476111 | Jeffrey C Miller Dds Inc | Dentist | 4450 Linden Ave, Dayton, OH 45432 | 2006-11-22 |
| 1194898098 | Joseph Warren Shiveley | Dentist | 1555 Marsetta Drive, Dayton, OH 45432 | 2006-11-16 |
| 1710907597 | Integrated Youth Services Inc | Clinic/Center | 1321 Research Park Drive, Dayton, OH 45432 | 2006-07-21 |
| 1730106790 | Lorena L Kvalheim | Psychologist | 1020 Woodman Street, Suite 300, Dayton, OH 45432 | 2006-07-16 |
| Find all providers in zip 45432 | ||||
| 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 |
|---|---|---|---|---|
| 1861091241 | Beau Webb | Physician Assistant | 6017 Cruxten Dr, Dayton, OH 45424-3702 | 2020-10-18 |
| 1043838782 | Marie Therese Mualla Oram | Physician Assistant | 204 Sears St Apt 518, Dayton, OH 45402-1573 | 2020-07-09 |
| 1720542509 | Herodina Ibanez Lu | Physician Assistant | 1 Elizabeth Pl Nwb Ste 15, Dayton, OH 45417-3445 | 2019-01-25 |
| 1427585819 | Mita Morar | Physician Assistant | 938 Olde Sterling Way, Dayton, OH 45459-3100 | 2017-05-16 |
| 1306394275 | Danielle Elizabeth Tirjer Cleary | Physician Assistant | 320 Judith Dr, Dayton, OH 45429-5306 | 2016-09-20 |
| 1831555234 | Lisa Byers | Physician Assistant | 7980 N Main St, Dayton, OH 45415-2328 | 2016-01-14 |
| 1205205358 | Kelby Snorf | Physician Assistant | 30 E Apple Street, Suite 3300, Dayton, OH 45409 | 2015-09-18 |
| 1104201730 | Dominique Hunt | Physician Assistant | 5300 Far Hills Ave Ste 300, Dayton, OH 45429-2381 | 2015-07-24 |
| 1285025957 | Holly Griffin | Physician Assistant | 4340 Clyo Rd, Dayton, OH 45459-7000 | 2015-02-16 |
| 1073885216 | Shawn Breeding | Physician Assistant | 627 Edwin C. Moses Blvd, Suite K, Dayton, OH 45417-3474 | 2012-02-03 |
| Find all providers in DAYTON | ||||
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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.