JENNY LEE MAHONEY (NPI# 1043863079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043863079 |
| Entity Type | Individual |
| Full Name | JENNY LEE MAHONEY |
| Credential | IDC |
| Practice Address |
55281 Yellow Jacket Dr Callahan FL 32011-8534 |
| Practice Telephone | 7576728533 |
| Mailing Telephone | 7576728533 |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2020-01-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2480 Bon Hommes Richard St, Jacksonville, FL 32227 | 9045422338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790180578 | Jenny Lynn Mahoney | Speech-Language Pathologist | 53 Youmans Ave, Washingtn, NJ 07882 | 2014-10-23 |
| 1073054581 | Jenny Mahoney | Registered Nurse | 1170 15th Ave Se, Minneapolis, MN 55414-2589 | 2017-03-16 |
| Street Address |
55281 YELLOW JACKET DR |
| City | CALLAHAN |
| State | FL |
| Zip Code | 32011-8534 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508327875 | Lathern Barnard Jones | Respiratory Therapist, Registered | 45772 Jones Way, Callahan, FL 32011 | 2019-03-28 |
| 1245799907 | Allan Harrison | Homemaker | 543514 Us Highway 1, Callahan, FL 32011 | 2019-03-13 |
| 1801360920 | Taylor Marie Catrett | Nurse Practitioner | 449621 Us Highway 201, Suite 201, Callahan, FL 32011 | 2019-01-11 |
| 1528369063 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 542356 Us Highway 1, Callahan, FL 32011 | 2010-11-16 |
| 1033310313 | James Roger Harrison | Dentist | 45390 Green Ave., Callahan, FL 32011 | 2007-05-31 |
| 1700993383 | William David Titus | Dentist | 542182 U. S. Highway 1, Callahan, FL 32011 | 2006-08-23 |
| 1083623953 | Bettye Ann Spillers | Registered Nurse | 45377 Mickler Street, Callahan, FL 32011 | 2006-08-07 |
| 1285691691 | Daniel Robert Weaver | Chiropractor | 542184 S Kings Rd, Space 3b, Callahan, FL 32011 | 2006-04-28 |
| 1780659169 | Cara A Lapkowicz | Podiatrist | 542067 Us Hwy 1, Callahan, FL 32011 | 2006-02-21 |
| 1245716836 | Haylie Whittenburg | Nurse Practitioner | 542325 Us Highway 1, Callahan, FL 32011 | 2018-07-17 |
| Find all providers in zip 32011 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740803725 | Alanna Gonzalez | Military Health Care Provider | 1453 Lindseys Crossing Dr, Jacksonville, FL 32218-8088 | 2020-05-25 |
| 1538793849 | Alberto Kris Cipollone | Military Health Care Provider | Bon Homme Richard Ave Bldg 2480, Jacksonville, FL 32246-0046 | 2020-02-25 |
| 1376175794 | James Ernest Claypool | Military Health Care Provider | 12411 Glenn Hollow Dr, Jacksonville, FL 32226-2349 | 2020-02-05 |
| 1831729821 | Michael O'connell | Military Health Care Provider | 8201 Bardmoor Pl Apt 203d, Seminole, FL 33777-1327 | 2020-01-19 |
| 1508404062 | Anthony Briel | Military Health Care Provider | 305 S Crag Road, Panama City, FL 32444 | 2019-12-16 |
| 1023546108 | Gregory Donald Willden | Military Health Care Provider | Bon Homme Richard St, Bldg 2480, Jacksonville, FL 32228 | 2017-06-01 |
| 1992230429 | George Williams Osorio | Military Health Care Provider | 1734 Forest Lakes Cir Apt D, West Palm Beach, FL 33406-5773 | 2017-04-21 |
| 1235681545 | Huriel A Rivera Aponte | Military Health Care Provider | Naval Station Mayport, Surflant Medical Readiness Division Detachment Mayport, Jacksonville, FL 32228 | 2016-11-03 |
| 1619420536 | Justin Allan Willis | Military Health Care Provider | 8353 Iris Ave, Seminole, FL 33777-3643 | 2016-07-27 |
| 1720531635 | Julian Vincent | Military Health Care Provider | 3861 Aubrey Ln, Orange Park, FL 32065-8224 | 2016-07-27 |
| Find all providers with the same taxonomy | ||||
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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.