Jason R Mayberry (NPI# 1255403861, PAC ID# 7416958632) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1255403861 |
| PAC ID by PECOS | 7416958632 |
| Professional Enrollment ID | I20161121001581 |
| Full Name | Jason R Mayberry |
| Organization Legal Name | PROVIDENCE HEALTH AND SERVICES-WA |
| Address |
101 W 8th Ave Spokane WA 99204-2307 |
| Phone Number | 5094743131 |
| Gender | M |
| Credential | PA |
| Graduation Year | 2006 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 7911069703 |
| Number of Group Practice Members | 20 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 500054 | PROVIDENCE SACRED HEART MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 101 W 8th Ave, Spokane, WA 99204-2307 | 5094743131 | PROVIDENCE HEALTH AND SERVICES-WA |
| 62 W 7th Ave, Spokane, WA 99204-2321 | PROVIDENCE HEALTH AND SERVICES-WA |
| Organization Legal Name | PROVIDENCE HEALTH AND SERVICES-WA |
| Physicians | 421 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tasneem Abbas Shikary | Otolaryngology | Providence Health and Services-wa | 1330 Rockefeller Ave, Suite 230, Everett, WA 98201-1676 |
| Nicole Kraker | Nurse Practitioner | Providence Health and Services-wa | 10200 Mukilteo Speedway, Mukilteo, WA 98275-4743 |
| Crystal L Blankinship | Clinical Social Worker | Providence Health and Services-wa | 1830 Bickford Ave, Suite 211, Snohomish, WA 98290-1751 |
| Lorena Barajas | Nurse Practitioner | Providence Health and Services-wa | 12728 19th Ave Se, Suite 200, Everett, WA 98208-6526 |
| Kim Quy V Nguyen | Nurse Practitioner | Providence Health and Services-wa | 19200 N Kelsey St, Monroe, WA 98272-1431 |
| Marianna Baghdasaryan | Nurse Practitioner | Providence Health and Services-wa | 13110 Bothell Everett Hwy, Everett, WA 98208-7202 |
| Tina Malm | Physician Assistant | Providence Health and Services-wa | 1321 Colby Ave, Everett, WA 98201-1665 |
| David Keisho Su | Neurosurgery | Providence Health and Services-wa | 1717 13th St, Suite 401, Everett, WA 98201-1621 |
| David B Shanholtzer | Nurse Practitioner | Providence Health and Services-wa | 12800 Bothell Everett Hwy, Everett, WA 98208-6642 |
| Laura Knapp Knapp | Clinical Social Worker | Providence Health and Services-wa | 1509 California St, Everett, WA 98201-3540 |
| Street Address |
101 W 8TH AVE |
| City | SPOKANE |
| State | WA |
| Zip | 99204-2307 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Thomas D Dea | Physician Assistant | Spokane Emergency Physicians Ps | 101 W 8th Ave, Spokane, WA 99204-2307 |
| Mary C Smith | Thoracic Surgery | Providence Health and Services-wa | 101 W 8th Ave, Spokane, WA 99204-2307 |
| Rita A Davis | Nurse Practitioner | Spokane Emergency Physicians Ps | 101 W 8th Ave, Spokane, WA 99204-2307 |
| Abdelrahman Fouad Ahmed Beltagy | Neurology | Providence Health and Services Washington | 101 W 8th Ave, Fl 3 North, Spokane, WA 99204-2307 |
| Christopher Scott Coons | Hospitalist | Providence Health and Services Washington | 101 W 8th Ave, 3rd Floor East, Spokane, WA 99204-2307 |
| Michael Petty | Certified Registered Nurse Anesthetist (crna) | Providence Health and Service- Washington | 101 W 8th Ave, Spokane, WA 99204-2307 |
| Joshua S Adams | Certified Registered Nurse Anesthetist (crna) | Providence Health and Service- Washington | 101 W 8th Ave, Spokane, WA 99204-2307 |
| Kurt W Kohler | Physician Assistant | Providence Health and Services-wa | 101 W 8th Ave, Spokane, WA 99204-2307 |
| Thomas A Satterfield | Anesthesiology | Providence Health and Service- Washington | 101 W 8th Ave, Spokane, WA 99204-2307 |
| Lesley Anne Cruz Portugal | Internal Medicine | Providence Health and Services Washington | 101 W 8th Ave, Spokane, WA 99204-2307 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elizabeth K Ohalloran | Family Practice | Providence Health and Services Washington | 105 E 8th Ave, Spokane, WA 99204 |
| Monica M Zherebtsov | Pediatric Medicine | Providence Health and Services Washington | 105 E 8th Ave, Suite 418, Spokane, WA 99204 |
| Mark P Guthrie | Chiropractic | Healing Center Inc. | 1625 W 4th Ave, Suite 200, Spokane, WA 99204-1720 |
| Kathleen D Lavis | Chiropractic | Healing Center Inc. | 1625 W 4th Ave, Suite 200, Spokane, WA 99204-1720 |
| Darcy A Kelly | Chiropractic | Healing Center Inc. | 1625 W 4th Ave, Suite 200, Spokane, WA 99204-1720 |
| Lucy E Peterson | Plastic and Reconstructive Surgery | 105 W 8th Ave, Spokane, WA 99204-2300 | |
| Kellen Ross Gumm | Physician Assistant | Providence Health and Services - Wa | 122 W 7th Ave, 110 Northwest Heart and Lung Surgical Association, Spokane, WA 99204-2301 |
| Maria C Cassel | Physician Assistant | Providence Health and Services - Wa | 122 W 7th Ave, Spokane, WA 99204-2301 |
| Michelle Minyoung Rhee | Physician Assistant | Providence Health and Services - Wa | 122 W 7th Ave, Spokane, WA 99204-2301 |
| Anisha Boetel | Psychiatry | Providence Health and Services Washington | 105 W 8th Ave, Suite 450e, Spokane, WA 99204-2302 |
| Find all physicians in zip 99204 | |||
| City | SPOKANE |
| Zip Code | 99204 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | SPOKANE + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Jason R Mayberry.
| 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.