John L Kittredge (NPI# 1750316196, PAC ID# 2567525660) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1750316196 |
| PAC ID by PECOS | 2567525660 |
| Professional Enrollment ID | I20090115000694 |
| Full Name | John L Kittredge |
| Organization Legal Name | MICHIANA SPINE, SPORTS AND OCCUPATIONAL REHAB, PC |
| Address |
3740 Edison Lakes Pkwy Mishawaka IN 46545-3448 |
| Phone Number | 5742524150 |
| Gender | M |
| Graduation Year | 1985 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 3375500093 |
| Number of Group Practice Members | 9 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 3740 Edison Lakes Pkwy, Mishawaka, IN 46545-3448 | 5742524150 | MICHIANA SPINE, SPORTS AND OCCUPATIONAL REHAB, PC |
| 24 N Saint Joseph Ave B, Niles, MI 49120-2263 | 2696846870 | MICHIANA SPINE, SPORTS AND OCCUPATIONAL REHAB, PC |
| 2946 Division St, Saint Joseph, MI 49085-2437 | 2694281550 | MICHIANA SPINE, SPORTS AND OCCUPATIONAL REHAB, PC |
| Organization Legal Name | MICHIANA SPINE, SPORTS AND OCCUPATIONAL REHAB, PC |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Caitlin M Vlaeminck | Nurse Practitioner | Michiana Spine, Sports and Occupational Rehab, PC | 3740 Edison Lakes Pkwy, Mishawaka, IN 46545-3448 |
| Mary Moore | Physical Therapy | Michiana Spine, Sports and Occupational Rehab, PC | 24 N Saint Joseph Ave B, Niles, MI 49120-2263 |
| Jonathan D Sanner | Physical Therapy | Michiana Spine, Sports and Occupational Rehab, PC | 555 W Crosstown Pkwy, Suite 201, Kalamazoo, MI 49008-1982 |
| Loraine A Fisher | Nurse Practitioner | Michiana Spine, Sports and Occupational Rehab, PC | 3740 Edison Lakes Pkwy, Mishawaka, IN 46545-3448 |
| Kevin Gene Drew | Interventional Pain Management | Michiana Spine, Sports and Occupational Rehab, PC | 3740 Edison Lakes Pkwy, Mishawaka, IN 46545-3448 |
| Cynthia Marie Turner | Physical Therapy | Michiana Spine, Sports and Occupational Rehab, PC | 555 W Crosstown Pkwy, Suite 201, Kalamazoo, MI 49008-1982 |
| Tamara K Jardine | Physical Therapy | Michiana Spine, Sports and Occupational Rehab, PC | 555 W Crosstown Pkwy, Suite 201, Kalamazoo, MI 49008-1982 |
| Timothy Swartz | Internal Medicine | Michiana Spine, Sports and Occupational Rehab, PC | 555 W Crosstown Pkwy, Suite 201, Kalamazoo, MI 49008-1982 |
| Street Address |
3740 EDISON LAKES PKWY |
| City | MISHAWAKA |
| State | IN |
| Zip | 46545-3448 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Caitlin M Vlaeminck | Nurse Practitioner | Michiana Spine, Sports and Occupational Rehab, PC | 3740 Edison Lakes Pkwy, Mishawaka, IN 46545-3448 |
| Loraine A Fisher | Nurse Practitioner | Michiana Spine, Sports and Occupational Rehab, PC | 3740 Edison Lakes Pkwy, Mishawaka, IN 46545-3448 |
| Kevin Gene Drew | Interventional Pain Management | Michiana Spine, Sports and Occupational Rehab, PC | 3740 Edison Lakes Pkwy, Mishawaka, IN 46545-3448 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Marielvea A Banks | Physician Assistant | Pic Indiana PC | 505 W Cleveland Rd, Mishawaka, IN 46545-1003 |
| Sean R Horner | Physician Assistant | Pic Indiana PC | 505 W Cleveland Rd, Mishawaka, IN 46545-1003 |
| Rami Musleh | Physician Assistant | Pic Indiana PC | 505 W Cleveland Rd, Mishawaka, IN 46545-1003 |
| Meghan M Barrus | Physician Assistant | Pic Indiana PC | 505 W Cleveland Rd, Mishawaka, IN 46545-1003 |
| Ann M Grubb | Physician Assistant | Pic Indiana PC | 505 W Cleveland Rd, Mishawaka, IN 46545-1003 |
| Duane M Wampler | Physician Assistant | Pic Indiana PC | 505 W Cleveland Rd, Mishawaka, IN 46545-1003 |
| Eugene Huang | Emergency Medicine | Pic Indiana PC | 505 W Cleveland Rd, Mishawaka, IN 46545-1003 |
| Steven D Whaley | Anesthesiology | Pic Indiana PC | 505 W Cleveland Rd, Mishawaka, IN 46545-1003 |
| Angela Blagojevski | Physician Assistant | Pic Indiana PC | 505 W Cleveland Rd, Mishawaka, IN 46545-1003 |
| Danny E Winn | Physician Assistant | Pic Indiana PC | 505 W Cleveland Rd, Mishawaka, IN 46545-1003 |
| Find all physicians in zip 46545 | |||
| City | MISHAWAKA |
| Zip Code | 46545 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | MISHAWAKA + PHYSICIAN ASSISTANT |
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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.