JARED ROSS TAYLOR (NPI# 1033359369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033359369 |
| Entity Type | Individual |
| Full Name | JARED ROSS TAYLOR |
| Credential | PA-C |
| Practice Address |
1100 Wilford Hall Loop Jbsa Lackland TX 78236 |
| Mailing Address |
4755 W Ann Rd North Las Vegas NV 89031-3424 |
| Practice Telephone | 2102924774 |
| Mailing Telephone | 7026450332 |
| Enumeration Date | 2009-02-26 |
| Last Update Date | 2018-06-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | FNP-363LF0000X | NV | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | NEVADA STATE BOARD OF PHARMACY | CS22548 | 01 |
| AZ | 414670 | 05 | |
| NV | NEVADA BOARD OF MEDICAL EXAMINERS | PA1142 | 01 |
| AZ | ARIZONA REGULATORY BOARD OF PHYSICIAN ASSISTANTS | 4378 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710041520 | Jared Michael Taylor | Chiropractor | 389 N 100 W Ste 1, Cedar City, UT 84720-2586 | 2006-12-19 |
| 1265490619 | Jared A Taylor | Optometrist | 409 Western Blvd, Suite 700, Jacksonville, NC 28546-6528 | 2006-05-03 |
| 1952949513 | Jared Tyson Taylor | Social Worker | 501 S Chipeta Way, Salt Lake City, UT 84108-1222 | 2019-12-13 |
| 1417449406 | Jared Lane Taylor | Health Educator | 780 S Guardsman Way, Salt Lake City, UT 84108-1374 | 2018-06-05 |
| 1760863161 | Jared Levi Taylor | Emergency Medicine | 1111 E Mcdowell Rd, Phoenix, AZ 85006-2612 | 2015-06-11 |
| 1154686541 | Jared Kerome Taylor | Psychiatry & Neurology | 2500 N State St, Jackson, MS 39216-4500 | 2012-07-11 |
| 1225359292 | Jared Lynn Taylor | Dentist | 855 E Warner Rd, 3104, Chandler, AZ 85225-0997 | 2010-06-14 |
| 1710111653 | Jared R. Taylor | Family Medicine | 8170 Laguna Blvd, Suite 010, Elk Grove, CA 95758-7901 | 2009-05-06 |
| 1023103926 | Jared M. Taylor | Social Worker | 175 W 1400 N, Suite A, Logan, UT 84341-6811 | 2006-10-04 |
| Street Address |
1100 WILFORD HALL LOOP |
| City | JBSA LACKLAND |
| State | TX |
| Zip Code | 78236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134113954 | Monica L. Wheaton | Advanced Practice Midwife | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2005-09-08 |
| 1811509763 | Megan Dial | Physical Therapist | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2020-08-21 |
| 1821614538 | Matthew Hetrick | Military Health Care Provider | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2020-06-18 |
| 1689297368 | Rachel E Hodge | Nurse Practitioner | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2020-05-28 |
| 1598385742 | Tora Jean Tornbom | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop, Bldg 4554, 59 Mdw/gme, Jbsa Lackland, TX 78236-5638 | 2020-04-17 |
| 1689236622 | Jessica Martinez Bennett | Nurse Practitioner | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2019-06-29 |
| 1073172565 | Robert A Kowtoniuk | General Practice | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2019-06-10 |
| 1972167161 | Jordan Ellis | Psychologist | 1100 Wilford Hall Loop, Bldg. 4554, 59 Mdw/gme, Jbsa Lackland, Jbsa Lackland, TX 78236 | 2019-04-24 |
| 1124580311 | Christopher Berrios | Military Health Care Provider | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2019-04-05 |
| 1801352539 | Aeja Weiss | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2019-02-19 |
| 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 | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831754886 | Meagan Theresa Ferguson | Physician Assistant | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 | 2019-05-06 |
| 1881153138 | Jessica-nicole Grogan | Physician Assistant | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 | 2019-03-17 |
| 1942715768 | Richard Siersma | Physician Assistant | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236 | 2017-12-04 |
| 1164936258 | Matthew Diotte | Physician Assistant | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 | 2017-11-28 |
| 1386180818 | Javier Porras | Physician Assistant | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 | 2017-01-08 |
| 1710439237 | Nicole Marie Baker | Physician Assistant | 1100 Wilford Hall Loop, Bldg 4554, Attn: 59 Mdw/sghc, Jbsa Lackland, TX 78236 | 2016-11-01 |
| 1386018778 | Craig Ameduri | Physician Assistant | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 | 2015-11-23 |
| 1083080691 | Chanise Cyrus | Physician Assistant | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 | 2015-08-18 |
| 1780062372 | Jason Simmons | Physician Assistant | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 | 2015-05-14 |
| 1063823458 | Thomas Vaughn | Physician Assistant | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 | 2014-05-19 |
| Find all providers in JBSA LACKLAND | ||||
| City | JBSA LACKLAND |
| 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.