Kenneth L Bryant (NPI# 1821007949, PAC ID# 1254433907) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
Nation Provider ID (NPI) | 1821007949 |
PAC ID by PECOS | 1254433907 |
Professional Enrollment ID | I20110301000414 |
Full Name | Kenneth L Bryant |
Organization Legal Name | JTDM FAMILY PRACTICE LLC |
Address |
200 Saint Clair Ave Suite 102 Saint Marys OH 45885-2400 |
Phone Number | 4193949512 |
Gender | M |
Medical School | WEST VIRGINIA SCHOOL OF OSTEOPATHIC MEDICINE |
Graduation Year | 1993 |
Primary Specialty | GENERAL SURGERY |
Group Practice PAC ID | 2163415837 |
Number of Group Practice Members | 36 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
360032 | GRAND LAKE HEALTH SYSTEM |
360058 | MERCER COUNTY JOINT TOWNSHIP COMMUNITY HOSPITAL |
Address | Phone | Organization |
---|---|---|
200 Saint Clair Ave, Suite 102, Saint Marys, OH 45885-2400 | 4193949512 | JTDM FAMILY PRACTICE LLC |
Organization Legal Name | JTDM FAMILY PRACTICE LLC |
Physicians | 35 |
Name | Specialty | Organization | Address |
---|---|---|---|
Christopher John Stucke | Podiatry | Jtdm Family Practice LLC | 1013 E Spring St, Saint Marys, OH 45885-2447 |
Kevin M Dirksen | Nurse Practitioner | Jtdm Family Practice LLC | 801 Pro Dr, D2, Celina, OH 45822-3307 |
James D Luedeke | Family Medicine | Jtdm Family Practice LLC | 4463 State Route 66, Minster, OH 45865-8727 |
Venkata Krishnarao Chalasani | Internal Medicine | Jtdm Family Practice LLC | 1010 Hager St, Saint Marys, OH 45885-2421 |
James A Reichert | General Surgery | Jtdm Family Practice LLC | 830 W Main St, Suite 101, Coldwater, OH 45828-1657 |
Mitchell E Nutt | Obstetrics/gynecology | Jtdm Family Practice LLC | 04463 State Route 66n, Suite A, Minster, OH 45865-8727 |
Dawn P Mcnaughton | Family Medicine | Jtdm Family Practice LLC | 1040 Hager St, Saint Marys, OH 45885-2421 |
James E Kemmler | Physical Medicine and Rehabilitation | Jtdm Family Practice LLC | 123 Hamilton St, Celina, OH 45822-1909 |
Jacqueline S Shriver | Nurse Practitioner | Jtdm Family Practice LLC | 1067 Hager St, Saint Marys, OH 45885-2422 |
Brooke A Lange | Physician Assistant | Jtdm Family Practice LLC | 801 Pro Dr, Celina, OH 45822-3307 |
Street Address |
200 SAINT CLAIR AVE SUITE 102 |
City | SAINT MARYS |
State | OH |
Zip | 45885-2400 |
Name | Specialty | Organization | Address |
---|---|---|---|
Adam Joseph Reidenbach | Certified Registered Nurse Anesthetist (crna) | Joint Township District Memorial Hospital | 200 Saint Clair Ave, Saint Marys, OH 45885-2400 |
Paul Martin Ferreira Leonard | Emergency Medicine | Joint Township District Memorial Hospital | 200 Saint Clair Ave, Saint Marys, OH 45885-2400 |
Amanda M Paden | Emergency Medicine | Joint Township District Memorial Hospital | 200 Saint Clair Ave, Saint Marys, OH 45885-2400 |
Joseph Anthony Perkins | Emergency Medicine | Joint Township District Memorial Hospital | 200 Saint Clair Ave, Saint Marys, OH 45885-2400 |
Steven Wing | Emergency Medicine | Joint Township District Memorial Hospital | 200 Saint Clair Ave, Saint Marys, OH 45885-2400 |
Natasha J Alexander | Neurology | Jtdm Family Practice LLC | 200 Saint Clair Ave, Suite 101, Saint Marys, OH 45885-2400 |
Seetaramaiah Annam | Anesthesiology | Joint Township District Memorial Hospital | 200 Saint Clair Ave, Saint Marys, OH 45885-2400 |
Angelo Collins | Family Medicine | Joint Township District Memorial Hospital | 200 Saint Clair Ave, Saint Marys, OH 45885-2400 |
Timothy James David Zwayer | Emergency Medicine | Joint Township District Memorial Hospital | 200 Saint Clair Ave, Saint Marys, OH 45885-2400 |
Seth Ochieng Agiro | Emergency Medicine | Joint Township District Memorial Hospital | 200 Saint Clair Ave, Saint Marys, OH 45885-2400 |
Find all physicians in the same address |
Name | Specialty | Organization | Address |
---|---|---|---|
Robert Spees | Chiropractic | 1633 Celina Rd, Saint Marys, OH 45885-1215 | |
Jeffrey S Chivington | Chiropractic | 575 Royal Oak Dr, Saint Marys, OH 45885-1465 | |
Margrete Anne Irish-pearson | Nurse Practitioner | Coleman Professional Services, Inc. | 720 Armstrong St, Saint Marys, OH 45885-1800 |
Jonathan R Tagle | Chiropractic | 153 E Spring St, St Marys, OH 45885-2311 | |
Michael R Compton | Chiropractic | 134 W Spring St, Saint Marys, OH 45885-2312 | |
John M Price | Optometry | 140 W Spring St, Saint Marys, OH 45885-2312 | |
Jessica Wilson | Emergency Medicine | Joint Township District Memorial Hospital | 200 Saint Clair Ave, Saint Marys, OH 45885-2400 |
Kenneth Lee Fox | Emergency Medicine | Joint Township District Memorial Hospital | 200 Saint Clair Ave, Saint Marys, OH 45885-2400 |
William Harr Iii | Certified Registered Nurse Anesthetist (crna) | Joint Township District Memorial Hospital | 200 Saint Clair Ave, Saint Marys, OH 45885-2400 |
Karen Green | Family Medicine | Joint Township District Memorial Hospital | 200 Saint Clair Ave, Saint Marys, OH 45885-2400 |
Find all physicians in zip 45885 |
City | SAINT MARYS |
Zip Code | 45885 |
Specialty | GENERAL SURGERY |
City + Specialty | SAINT MARYS + GENERAL SURGERY |
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Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.