Mark Stuart Jeffries (NPI# 1568458040, PAC ID# 6901701309) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1568458040 |
| PAC ID by PECOS | 6901701309 |
| Professional Enrollment ID | I20031126000537 |
| Full Name | Mark Stuart Jeffries |
| Organization Legal Name | PROVIDENCE MEDICAL GROUP |
| Address |
2912 Springboro W Suite 201 Moraine OH 45439-1674 |
| Phone Number | 9372978999 |
| Gender | M |
| Credential | MD |
| Medical School | WEST VIRGINIA SCHOOL OF OSTEOPATHIC MEDICINE |
| Graduation Year | 1995 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 2860386349 |
| Number of Group Practice Members | 37 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 360133 | GRANDVIEW AND SOUTHVIEW HOSPITALS |
| 360051 | MIAMI VALLEY HOSPITAL |
| 360079 | KETTERING MEDICAL CENTER |
| 360239 | KETTERING MEDICAL CENTER - SYCAMORE |
| Address | Phone | Organization |
|---|---|---|
| 2912 Springboro W, Suite 201, Moraine, OH 45439-1674 | 9372978999 | PROVIDENCE MEDICAL GROUP |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| MIPS_EC_047_overall | Care Plan | 28% | |
| MIPS_EC_333_overall | Adult Sinusitis: Computerized Tomography (CT) for Acute Sinusitis (Overuse) (100%: worst, 0% best) | 0% |
| Organization Legal Name | PROVIDENCE MEDICAL GROUP |
| Physicians | 50 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Theresa Kay Edwards | Nurse Practitioner | Providence Medical Group | 8701 Troy Pike, Suite 20, Huber Heights, OH 45424-1073 |
| Timothy D Webb | Family Medicine | Providence Medical Group | 4403 W Franklin St D, Bellbrook, OH 45305-2700 |
| Krista A Miller | Nurse Practitioner | Providence Medical Group | 49 E Ctr St, Farmersville, OH 45325-1110 |
| Caitlyn Frantz | Nurse Practitioner | Providence Medical Group | 6255 Chambersburg Rd, Huber Heights, OH 45424-3873 |
| Meta Lisa Howard | Nurse Practitioner | Providence Medical Group | 400 Corporate Ctr Dr, Vandalia, OH 45377-1164 |
| Kristen M Schwieterman | Nurse Practitioner | Providence Medical Group | 4353e State Route 73, Waynesville, OH 45068-8812 |
| Kevin A Carter | Family Medicine | Providence Medical Group | 38 Woodcroft Trl, Beavercreek, OH 45430-1980 |
| Shane T Sampson | Family Medicine | Providence Medical Group | 2912 Springboro W, Moraine, OH 45439-1674 |
| Mary F Sroga | Nurse Practitioner | Providence Medical Group | 1870 Dayton Germantown Pike, Germantown, OH 45327-1100 |
| James R Fisco | Family Medicine | Providence Medical Group | 70 Remick Blvd, Springboro, OH 45066-9168 |
| Street Address |
2912 SPRINGBORO W SUITE 201 |
| City | MORAINE |
| State | OH |
| Zip | 45439-1674 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shane T Sampson | Family Medicine | Providence Medical Group | 2912 Springboro W, Moraine, OH 45439-1674 |
| Mijanou D Marretta-lewis | Nurse Practitioner | Providence Medical Group | 2912 Springboro W, Moraine, OH 45439-1674 |
| Victoria E Brookshire | Nurse Practitioner | Providence Medical Group | 2912 Springboro W, Suite 201, Moraine, OH 45439-1674 |
| Jeffrey Blake Gleick | Family Medicine | Providence Medical Group | 2912 Springboro W, Moraine, OH 45439-1674 |
| Edward J Kinkopf | Family Practice | Providence Medical Group | 2912 Springboro W, Suite 201a, Moraine, OH 45439-1674 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bonnie R Parish | Clinical Social Worker | Family Service Association | 2211 Arbor Blvd, Moraine, OH 45439-1521 |
| Joanna White | Clinical Social Worker | Family Service Association | 2211 Arbor Blvd, Moraine, OH 45439-1521 |
| Cheryl E Hamant Roslund | Clinical Social Worker | Family Service Association | 2211 Arbor Blvd, Moraine, OH 45439-1521 |
| Rakesh K Gupta | Nephrology | Renal Physicians Inc | 2016 Springboro W, Moraine, OH 45439-1648 |
| Jerry E Flexman | Psychologist, Clinical | Flexman Myers Clinic LLC | 2621 Dryden Rd, Suite 202, Moraine, OH 45439-1661 |
| Katherine Myers | Psychologist, Clinical | Flexman Myers Clinic LLC | 2621 Dryden Rd, Suite 202, Moraine, OH 45439-1661 |
| Thomas H Henderson | Family Practice | Providence Medical Group | 2912 Springboro Rd W, Moraine, OH 45439-1674 |
| Emma E Garcia | Family Practice | Providence Medical Group | 2912 Springboro Rd W, Suite 201, Moraine, OH 45439-1674 |
| Patrice E Christie | Physician Assistant | Providence Medical Group | 2912 Springboro Rd W, Suite 201, Moraine, OH 45439-1674 |
| Sullivan Doumont | Physician Assistant | Providence Medical Group | 2912 Springboro Rd W, Suite 201, Moraine, OH 45439-1674 |
| Find all physicians in zip 45439 | |||
| City | MORAINE |
| Zip Code | 45439 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | MORAINE + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Mark Stuart Jeffries.
| 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.