MR. JOSE LUIS DELGADO III (NPI# 1053692657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053692657 |
| Entity Type | Individual |
| Full Name | MR. JOSE LUIS DELGADO III |
| Practice Address |
244 Ohio Ave Groton CT 06340-6109 |
| Practice Telephone | 8608573279 |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2011-09-09 |
| Gender Code | M |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639430523 | Jose Alfonso Delgado Jr. | Marriage & Family Therapist | 12014 Wimberly Ave, Sylmar, CA 91342-5459 | 2012-06-06 |
| 1932321205 | Jose Manuel Delgado | Dentist | 74-09 37th Avenue, Suite 301, Jackson Heights, NY 11372 | 2007-05-03 |
| 1306923115 | Jose Delgado | Psychiatry & Neurology | 466 County Street, New Bedford, MA 02740-0155 | 2006-11-01 |
| 1629172879 | Jose Juan Delgado | Counselor | Cmr 454 Box 2062, Jose J Delgado, Apo, AE 09250 | 2006-09-11 |
| 1013931179 | Jose David Delgado | Family Medicine | 5240 E. Beverly Blvd., Los Angeles, CA 90022-2002 | 2006-07-26 |
| 1578581658 | Jose A. Delgado | Chiropractor | 1295 Peoria St, Washington, IL 61571-2352 | 2006-07-17 |
| 1801889688 | Jose O Delgado | Internal Medicine | 2801 Se 1st Ave Ste 302, Ocala, FL 34471 | 2005-08-26 |
| 1841784006 | Jose Delgado | Behavior Technician | 2565 Alluvial Ave Ste 152, Clovis, CA 93611-9514 | 2018-06-20 |
| 1861984882 | Jose Delgado | Case Manager/Care Coordinator | 2001 The Alameda, San Jose, CA 95126-1136 | 2018-06-05 |
| 1265603880 | Jose Antonio Delgado | Internal Medicine | 3800 Reservoir Rd Nw, Washington, DC 20007-2113 | 2008-03-23 |
| Street Address |
244 OHIO AVE |
| City | GROTON |
| State | CT |
| Zip Code | 06340-6109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912558610 | Bruce Lancel Bernardo Lara | Military Health Care Provider | Fpo, Ae, 09587-2417, Groton, AE 06340 | 2019-09-24 |
| 1295393692 | Ermelinda Elaine Alviso | Military Health Care Provider | Trout Ave, Groton, CT 06340 | 2019-05-31 |
| 1679034011 | Derek James Hale | Military Health Care Provider | Fc 83 Numi, Trout Ave, Groton, CT 06340 | 2019-03-28 |
| 1063973790 | Cody Eugene Shaw | Military Health Care Provider | Numi, Trout Ave Building 83, Groton, CT 06340 | 2019-03-26 |
| 1265906911 | Homelife Companions and Homemakers, LLC | Adult Companion | 1 Fort Hill Road, Suite 3, Groton, CT 06340 | 2019-01-16 |
| 1144735457 | Kristina Marie Carta | Behavior Technician | 220 Rt 12, Suite 205, Groton, CT 06340 | 2017-12-08 |
| 1538674262 | Tercel Dental Pllc | Dentist | 643 Gold Star Hwy., Groton, CT 06340 | 2017-12-04 |
| 1306361662 | Stonington Behavioral Health Inc | Psychologist | 618 Poquonnock Rd, Groton, CT 06340 | 2017-08-08 |
| 1104347806 | Renae Reynolds | Optometrist | 489 Gold Star Hwy Ste 100, Groton, CT 06340 | 2017-07-03 |
| 1053831552 | Susan A Bradbury | Physical Therapist | 455 Eastern Point Rd, Groton, CT 06340 | 2017-06-26 |
| Find all providers in zip 06340 | ||||
| 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 |
|---|---|---|---|---|
| 1063052819 | Kenny Daniel Harp | Military Health Care Provider | 59 Deerwood Dr, Groton, CT 06340-2513 | 2020-01-09 |
| 1982244737 | Lonnie Jay Reardon | Military Health Care Provider | 55 South Rd Apt 12c, Groton, CT 06340-4660 | 2020-01-09 |
| 1376194274 | Christopher Lee Roy Smith | Military Health Care Provider | Uss San Juan (ssn 751), Groton, CT 06349 | 2019-09-23 |
| 1679132112 | Hector Salvador Gonzalez | Military Health Care Provider | 2 Bushnell St, Groton, CT 06340-3306 | 2019-06-09 |
| 1295393692 | Ermelinda Elaine Alviso | Military Health Care Provider | Trout Ave, Groton, CT 06340 | 2019-05-31 |
| 1558929026 | Joshua Darren Savage | Military Health Care Provider | 35 Chrissos St, Groton, CT 06340-3307 | 2019-05-30 |
| 1679034011 | Derek James Hale | Military Health Care Provider | Fc 83 Numi, Trout Ave, Groton, CT 06340 | 2019-03-28 |
| 1063973790 | Cody Eugene Shaw | Military Health Care Provider | Numi, Trout Ave Building 83, Groton, CT 06340 | 2019-03-26 |
| 1689179640 | David Saunders | Military Health Care Provider | 159 Navsubase Nlon, Groton, CT 06349 | 2018-03-29 |
| 1992241228 | Phillip Lawernce Hardy Sr. | Military Health Care Provider | 123 Trout Ave, Naval Undersea Medical Institiute, Groton, CT 06340-5159 | 2017-01-10 |
| Find all providers in GROTON | ||||
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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.