Jetta D Ange (NPI# 1336686492, PAC ID# 4981989936) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1336686492 |
| PAC ID by PECOS | 4981989936 |
| Professional Enrollment ID | I20170314001779 |
| Full Name | Jetta D Ange |
| Organization Legal Name | ARKANSAS VERDIGRIS VALLEY HEALTH CENTERS,INC. |
| Address |
201 N 32nd St Muskogee OK 74401-2104 |
| Phone Number | 9189122333 |
| Gender | F |
| Graduation Year | 2016 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 2961594916 |
| Number of Group Practice Members | 8 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 370025 | SAINT FRANCIS HOSPITAL MUSKOGEE |
| Address | Phone | Organization |
|---|---|---|
| 201 N 32nd St, Muskogee, OK 74401-2104 | 9189122333 | ARKANSAS VERDIGRIS VALLEY HEALTH CENTERS,INC. |
| 619 N Main St, Bldg D, Muskogee, OK 74401-4431 | 9186820222 | ARKANSAS VERDIGRIS VALLEY HEALTH CENTERS,INC. |
| 619 N Main St, Muskogee, OK 74401-4431 | 9186828407 | GREEN COUNTRY BEHAVIORAL HEALTH SERVICES, INC. |
| Organization Legal Name | ARKANSAS VERDIGRIS VALLEY HEALTH CENTERS,INC. |
| Physicians | 8 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ashley N Aldrich | Family Medicine | Arkansas Verdigris Valley Health Centers,inc. | 201 N 32nd St, Muskogee, OK 74401-2104 |
| Johnson C Gourd Jr. | Family Medicine | Arkansas Verdigris Valley Health Centers,inc. | 619 N Main St, Bldg D, Muskogee, OK 74401-4431 |
| Kendra Seccombe | Nurse Practitioner | Arkansas Verdigris Valley Health Centers,inc. | 201 N 32nd St, Muskogee, OK 74401-2104 |
| Alan L Brokenicky | Physician Assistant | Arkansas Verdigris Valley Health Centers,inc. | 619 N Main St, Bldg D, Muskogee, OK 74401-4431 |
| Jennifer Lyn Stickelmeyer | Nurse Practitioner | Arkansas Verdigris Valley Health Centers,inc. | 201 N 32nd St, Muskogee, OK 74401-2104 |
| Stephanie J Garrett | Physician Assistant | Arkansas Verdigris Valley Health Centers,inc. | 201 N 32nd St, Muskogee, OK 74401-2104 |
| Caitlin M Ashley | Physician Assistant | Arkansas Verdigris Valley Health Centers,inc. | 201 N 32nd St, Muskogee, OK 74401-2104 |
| Street Address |
201 N 32ND ST |
| City | MUSKOGEE |
| State | OK |
| Zip | 74401-2104 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ashley N Aldrich | Family Medicine | Arkansas Verdigris Valley Health Centers,inc. | 201 N 32nd St, Muskogee, OK 74401-2104 |
| Kendra Seccombe | Nurse Practitioner | Arkansas Verdigris Valley Health Centers,inc. | 201 N 32nd St, Muskogee, OK 74401-2104 |
| Jennifer Lyn Stickelmeyer | Nurse Practitioner | Arkansas Verdigris Valley Health Centers,inc. | 201 N 32nd St, Muskogee, OK 74401-2104 |
| Stephanie J Garrett | Physician Assistant | Arkansas Verdigris Valley Health Centers,inc. | 201 N 32nd St, Muskogee, OK 74401-2104 |
| Caitlin M Ashley | Physician Assistant | Arkansas Verdigris Valley Health Centers,inc. | 201 N 32nd St, Muskogee, OK 74401-2104 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stephen M Patton | Psychiatry | 841 N 38th St, Brentwood Extended Care and Rehab LLC, Muskogee, OK 74401-2056 | |
| Erik E Paulson | Diagnostic Radiology | Landmark Cancer Center Gp LLC | 301 N 32nd St, Muskogee, OK 74401-2106 |
| Ravikumar Vasireddy | Hematology/oncology | Landmark Cancer Center Gp LLC | 301 N 32nd St, Muskogee, OK 74401-2106 |
| Bilal Ahmad | Hematology/oncology | Pinnacle Oncology Oklahoma PC | 301 N 32nd St, Muskogee, OK 74401-2106 |
| Steven Ciglar | Diagnostic Radiology | Landmark Cancer Center Gp LLC | 301 N 32nd St, Muskogee, OK 74401-2106 |
| Teresa G Craig | Radiation Oncology | Landmark Cancer Center Gp LLC | 301 N 32nd St, Muskogee, OK 74401-2106 |
| Heath A Vandelinder | Diagnostic Radiology | Landmark Cancer Center Gp LLC | 301 N 32nd St, Muskogee, OK 74401-2106 |
| Craige M Brestel | Obstetrics/gynecology | 3401 W Broadway, Muskogee, OK 74401-2136 | |
| David R Powell | Obstetrics/gynecology | 3401 W Broadway, Muskogee, OK 74401-2136 | |
| Muhammad Ali | Physical Therapy | 3619 W Broadway St, Muskogee, OK 74401-2140 | |
| Find all physicians in zip 74401 | |||
| City | MUSKOGEE |
| Zip Code | 74401 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | MUSKOGEE + 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.