ZACHARY PETTIBONE (NPI# 1962821447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962821447 |
| Entity Type | Individual |
| Full Name | ZACHARY PETTIBONE |
| Practice Address |
4075 Old Western Row Rd Mason OH 45040 |
| Mailing Address |
4075 Old Western Row Rd Mason OH 45040-3104 |
| Practice Telephone | 5135364673 |
| Practice Fax Number | 5135583477 |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2018-06-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
4075 OLD WESTERN ROW RD |
| City | MASON |
| State | OH |
| Zip Code | 45040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891793220 | Carol Blankemeyer Dewald | Registered Nurse | 4075 Old Western Row Rd, Mason, OH 45040-3104 | 2005-07-11 |
| 1477171346 | Kimberly Spivey | Registered Nurse | 4075 Old Western Row Rd, Mason, OH 45040-3104 | 2020-07-08 |
| 1154989663 | Jessica Lynn Kraft | Nurse Practitioner | 4075 Old Western Row Rd, Mason, OH 45040-3104 | 2019-05-30 |
| 1447816905 | Allison Mecca | Psychologist | 4075 Old Western Row Rd, Mason, OH 45040-3104 | 2019-05-10 |
| 1407353618 | Erin Catherine Snider | Nurse Practitioner | 4075 Old Western Row Rd, Mason, OH 45040 | 2018-04-12 |
| 1356849384 | Stephanie Paige Kisling | Case Manager/Care Coordinator | 4075 Old Western Row Rd, Mason, OH 45040-3104 | 2018-01-24 |
| 1982127122 | Danielle Beltz | Nurse Practitioner | 4075 Old Western Row Rd, Mason, OH 45040-3104 | 2017-07-19 |
| 1023539517 | Anna Ward | Registered Nurse | 4075 Old Western Row Rd, Mason, OH 45040-3104 | 2017-07-05 |
| 1912433574 | Jennifer Milau | Registered Nurse | 4075 Old Western Row Rd, Mason, OH 45040-3104 | 2017-05-02 |
| 1215476767 | Jennifer B Wilcox | Psychologist | 4075 Old Western Row Rd, Mason, OH 45040-3104 | 2017-02-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336633882 | Jarek Beegan | Specialist/Technologist, Other | 8188 Corporate Way, Mason, OH 45040 | 2018-06-19 |
| 1548771439 | Jeanene Gibson | Registered Nurse | 9945 Coventry Court, Mason, OH 45040 | 2017-10-18 |
| 1093249898 | Peace of Mind Care Services, Inc. | Community/Behavioral Health | 5180 Cedar Village Drive, Suite A, Mason, OH 45040 | 2017-04-18 |
| 1477938736 | Justin William Florek | Chiropractor | 6213 Snider Road, Mason, OH 45040 | 2015-07-28 |
| 1730562729 | Alexandra Courts | Physical Therapist | 5267 Joseph Ln, Mason, OH 45040 | 2015-07-08 |
| 1982083531 | Nicole Roether | Specialist/Technologist | 5236 Socialville-foster Road, Mason, OH 45040 | 2015-05-28 |
| 1568849123 | Alissa Marie Conde | Pediatrics | 9560 Children's Drive, Mason, OH 45040 | 2015-05-04 |
| 1205220696 | Elizabeth Barnes | Pain Medicine | 3611 Socialville-foster Rd, Suite 101, Mason, OH 45040 | 2015-03-24 |
| 1669864807 | Lang Truong | Pharmacist | 5542 Red Fox Ct, Mason, OH 45040 | 2015-02-25 |
| 1295133668 | Gregory Carr | Psychologist | 4569 Wesley Ct, Mason, OH 45040 | 2014-12-16 |
| Find all providers in zip 45040 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134640469 | Eric Thomas Fink | Student in an Organized Health Care Education/Training Program | 1355 W Howell Rd, Mason, MI 48854-9307 | 2017-06-27 |
| 1871913566 | Zarina Sharalaya | Student in an Organized Health Care Education/Training Program | 4137 Westridge Dr, Mason, OH 45040-4703 | 2014-04-21 |
| 1881983062 | Christopher T. Short | Student in an Organized Health Care Education/Training Program | 3509 Gainsville Rd, Mason, TN 38049-6802 | 2011-03-28 |
| 1487068292 | Dajouir Cornnielies | Student in an Organized Health Care Education/Training Program | 4471 English Oak Ct, Mason, OH 45040-2531 | 2014-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073114195 | Madeline Rose Barnes | Student in an Organized Health Care Education/Training Program | 11322 Wilderness Way Ct, Belle Center, OH 43310-9330 | 2020-11-04 |
| 1073113940 | Chelsea Ann Winner | Student in an Organized Health Care Education/Training Program | 7395 State Route 119, Maria Stein, OH 45860-8717 | 2020-10-29 |
| 1770182578 | Abigail Morgan Naegele | Student in an Organized Health Care Education/Training Program | 9604 County Road 107 Unit 26, Proctorville, OH 45669-8023 | 2020-10-22 |
| 1720687833 | Bethany C Eagle | Student in an Organized Health Care Education/Training Program | 1015 Taylor Rd, Mansfield, OH 44903-7683 | 2020-10-20 |
| 1013515493 | Jonathan Ehrenkrantz | Student in an Organized Health Care Education/Training Program | 5720 Reigart Rd, Fairfield Township, OH 45011-2160 | 2020-10-16 |
| 1205434925 | Madeline Mae Juergens | Student in an Organized Health Care Education/Training Program | 3600 Colonel Glenn Hwy 117 Health Sciences Bldg, Dayton, OH 45435-0001 | 2020-10-14 |
| 1871190546 | Philip Maxwell Wienkamp | Student in an Organized Health Care Education/Training Program | 6194 Oakhaven Dr, Cincinnati, OH 45233-4444 | 2020-10-06 |
| 1922615335 | Ijeoma Osigwe | Student in an Organized Health Care Education/Training Program | 380 Butterfly Gardens Dr Ste 4a, Columbus, OH 43215-7508 | 2020-09-29 |
| 1407463862 | Kim El Haddad | Student in an Organized Health Care Education/Training Program | Cleveland Clinic Main Campus 9500 Euclid Avenue/na-23, Cleveland, OH 44195-0001 | 2020-09-29 |
| 1376150854 | Diana Lynne Warner | Student in an Organized Health Care Education/Training Program | 7663 Fairground Rd, Blanchester, OH 45107-1548 | 2020-09-28 |
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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.