DANIELLE KUSSEROW BERSABE (NPI# 1003177593) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003177593 |
| Entity Type | Individual |
| Full Name | DANIELLE KUSSEROW BERSABE |
| Credential | M.D. |
| Practice Address |
2200 Bergquist Dr Wilford Hall Ambulatory Surgical Center Lackland A F B TX 78236-9907 |
| Mailing Address |
2200 Berquist Dr Internal Medicine Clinic Lackland Afb TX 78233 |
| Practice Telephone | 2102927805 |
| Practice Fax Number | 2102927868 |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2015-10-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 0101255839 | VA | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | 0101255839 | VA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | TX | Student, Health Care |
| Street Address |
2200 BERGQUIST DR WILFORD HALL AMBULATORY SURGICAL CENTER |
| City | LACKLAND A F B |
| State | TX |
| Zip Code | 78236-9907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235139494 | Kathryn Joyce | Nurse Practitioner | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2005-07-28 |
| 1619219789 | Jodie K Timberlake | Student in an Organized Health Care Education/Training Program | 2200 Bergquist Dr, Willford Hall Ambulatory Surgical Center, Lackland A F B, TX 78236-9907 | 2013-03-26 |
| 1467798884 | James W Parry | Military Health Care Provider | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2012-12-13 |
| 1093065252 | Brittany Mccright | Physical Therapist | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2012-09-14 |
| 1114206570 | Ana Ugues Aleman | Pharmacist | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2011-08-16 |
| 1902192743 | Ashley Noelle Franz | Student in an Organized Health Care Education/Training Program | 2200 Bergquist Dr, Wilford Hall Medical Center, Lackland A F B, TX 78236-9907 | 2011-06-20 |
| 1699067694 | Kristen Kann | Emergency Medicine | 2200 Bergquist Dr, Suite 1, Lackland A F B, TX 78236-9907 | 2011-05-09 |
| 1891090577 | Evan Gregory Smith | Physician Assistant | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2011-01-11 |
| 1295041853 | Santos Michael Rivera II | Pharmacist | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2010-08-20 |
| 1245545151 | Corey Dequan Cooper | Pharmacist | 2200 Bergquist Dr, Suite 1, Lackland A F B, TX 78236-9907 | 2010-08-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
| 1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
| 1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
| 1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
| 1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
| 1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
| 1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
| 1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
| 1376906958 | David Kephart Jr. | General Practice | 1100 Wilford Hall Loop Bldg 4454, Jbsa Lackland, TX 78236 | 2016-04-01 |
| 1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
| Find all providers in zip 78236 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508177387 | Wassem Juakiem | Internal Medicine | 2200 Bergquist Dr, Internal Medicine/sg05v, Lackland A F B, TX 78236-9907 | 2010-06-28 |
| 1164593174 | Julianne Flynn | Internal Medicine | 2200 Bergquist Dr, Ste 1, Attn Credentials (cmc), Lackland A F B, TX 78236-9907 | 2006-11-13 |
| 1992875876 | Rechell Rodriguez | Internal Medicine | 2200 Bergquist Dr Ste 1, Attn Credentials Cmc, Lackland A F B, TX 78236-5300 | 2006-11-08 |
| 1265452734 | Doris Lundberg | Internal Medicine | 2200 Bergquist Dr Ste 1, Lackland A F B, TX 78236-9908 | 2006-07-20 |
| 1043235062 | Jill L Sterling | Internal Medicine | 2200 Bergquist Dr Ste 1, Attn: Credentials (cmc), Lackland A F B, TX 78236-9908 | 2006-07-12 |
| 1811960289 | David G Young IIi | Internal Medicine | 2200 Bergquist Dr, Suite 1, Attn Credentials Cmc, Lackland A F B, TX 78236-9907 | 2006-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295334936 | Samantha H. Goodman, Md, Pllc | Internal Medicine | 3926 S Treadaway Blvd Ste B2, Abilene, TX 79602-6939 | 2020-10-23 |
| 1750989109 | 3d Regeneration LLC | Internal Medicine | 11610 Bee Caves Rd Ste 230, Austin, TX 78738-5457 | 2020-10-16 |
| 1174121552 | Taiwo Kuye, Md Pa | Internal Medicine | 7135 N Expressway 77 Ste C, Olmito, TX 78575-5204 | 2020-10-16 |
| 1760080014 | Stephanie Kennedy | Internal Medicine | 503 E Sonterra Blvd, San Antonio, TX 78258-4058 | 2020-10-09 |
| 1588262711 | Medicus Internal Medicine & Primary Care Pllc | Internal Medicine | 2822 Dogwood Terrace Ln, Katy, TX 77494-7166 | 2020-10-09 |
| 1588261002 | Cardiac Rhythm Center Pllc | Internal Medicine | 2527 Gramercy St, Houston, TX 77030-3107 | 2020-10-07 |
| 1982210571 | Kim L Rowlands | Internal Medicine | 6101 E Oltorf, None, Austin, TX 78704-7875 | 2020-09-18 |
| 1891301438 | Primary Care of Houston Pllc | Internal Medicine | 19255 Park Row Ste 204b, Houston, TX 77084-7310 | 2020-09-18 |
| 1225644065 | Seton Family of Doctors | Internal Medicine | 3001 Palm Way, D1 : 134-138, Austin, TX 78758 | 2020-09-17 |
| 1528674561 | Knight Doctor Pllc | Internal Medicine | 1401 Eva St Apt 304, Austin, TX 78704-3069 | 2020-09-16 |
| Find all providers with the same taxonomy | ||||
| City | LACKLAND A F B |
| Zip Code | 78236 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.