| Geriatric Care Providers Inc | |
|
1896 Amys Ridge Ct Beavercreek OH 45434-7192 | |
| (937) 671-7028 | |
| (937) 534-0166 |
| Full Name | Geriatric Care Providers Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1896 Amys Ridge Ct, Beavercreek, Ohio |
| Authorized Official Name and Position | Rachel Hunter (OWNER) |
| Authorized Official Contact | 9376717028 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Geriatric Care Providers Inc 1896 Amys Ridge Ct Beavercreek OH 45434-7192 Ph: (937) 671-7028 | Geriatric Care Providers Inc 1896 Amys Ridge Ct Beavercreek OH 45434-7192 Ph: (937) 671-7028 |
| NPI Number | 1790343846 |
|---|---|
| Provider Enumeration Date | 06/04/2019 |
| Last Update Date | 03/09/2021 |
| Certification Date | 03/09/2021 |
| Medicare PECOS PAC ID | 1052744885 |
|---|---|
| Medicare Enrollment ID | O20191209000672 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790343846 | NPI | - | NPPES |
| H633650 | Other | OH | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | () | Primary |
| Provider Name | Robert L Hunter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114920485 PECOS PAC ID: 3476520727 Enrollment ID: I20040915000584 |
| Provider Name | Kimberly Sunshein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649258328 PECOS PAC ID: 5395796759 Enrollment ID: I20050203000244 |
| Provider Name | Rachel Lynn Hunter |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1851379309 PECOS PAC ID: 9234201799 Enrollment ID: I20180718003811 |
| Provider Name | Robert Andre De Roziere |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396200523 PECOS PAC ID: 0143568139 Enrollment ID: I20190218001298 |
| Provider Name | Carrie Steward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023650165 PECOS PAC ID: 1658707914 Enrollment ID: I20200204002426 |
| Provider Name | Philip Spicer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730786757 PECOS PAC ID: 4688084106 Enrollment ID: I20201111001915 |
| Provider Name | Shonda L Terrazas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043809767 PECOS PAC ID: 2961819552 Enrollment ID: I20210329002166 |
| Provider Name | Sandra Hoke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881270049 PECOS PAC ID: 7113327206 Enrollment ID: I20210610002734 |
| Provider Name | Peggy D Gildenblatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649944919 PECOS PAC ID: 0840695565 Enrollment ID: I20210818003004 |
| Provider Name | Camren Christopher Lee Moore |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619741527 PECOS PAC ID: 1951746338 Enrollment ID: I20240226000187 |
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