JACK MATHEW DAVIS (NPI# 1063529162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063529162 |
| Entity Type | Individual |
| Full Name | JACK MATHEW DAVIS |
| Credential | FNP |
| Practice Address |
18th Medcom Attn: Dccs-qm (credentials) Apo AP 96205-0054 KR |
| Mailing Address |
3523 Trailway Park St San Antonio TX 78247-2927 |
| Practice Telephone | 011-822-7916-6027 |
| Practice Fax Number | 011-822-7917-8110 |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN073330 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447817127 | Jack Wayland Davis II | Student in an Organized Health Care Education/Training Program | 1109 Flagship Dr, Vallejo, CA 94592-1114 | 2019-05-29 |
| 1225104250 | Jack M Davis | Podiatrist | 2251 W 900 N, Farr West, UT 84404-9586 | 2006-11-28 |
| 1235242652 | Jack Justin Davis | Dentist | 543 West Ave, Rifle, CO 81650-3553 | 2006-08-17 |
| 1396297966 | Jack Davis | Peer Specialist | 665 136th Ave, Suite 50, Holland, MI 49424-1897 | 2016-10-31 |
| Street Address |
18TH MEDCOM ATTN: DCCS-QM (CREDENTIALS) |
| City | APO |
| State | AP |
| Zip Code | 96205-0054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275521403 | Daniel Jeffrey Silvia | Social Worker | 18th Medcom, Attn: Dccs-qm (credentials), Apo, AP 96205-0054 | 2005-10-12 |
| 1275728578 | Deborah Susan Depastina | Dietitian, Registered | 18th Medcom, Apo, SEOUL 96205 | 2007-09-10 |
| 1912127283 | Joel Wilbert Barber | Social Worker | 18th Medcom, Attn Dccs Qm, Apo, AP 96205-0054 | 2007-04-27 |
| 1790822799 | Paul Woochul Chung | Military Health Care Provider | 18th Medcom, Attn Dccs Qm Credentials, Apo, AP 96205 | 2007-01-31 |
| 1285790949 | Laurel S Fields | Pharmacist | 18th Medcom, Attn Dccs Qm Credentials, Apo, AP 96205-0054 | 2006-12-28 |
| 1376632216 | Russell Menard | Counselor | 18th Medcom, Attn: Dccs-qm (credentials), Apo, AP 96205-0054 | 2006-10-11 |
| 1285722173 | Jay B Baker II | Emergency Medicine | 18th Medcom, Attn: Dccs-qm (credentials), Apo, AP 96205-0054 | 2006-10-10 |
| 1427169200 | Andy H. Song | Physician Assistant | 18th Medcom, Attn: Dccs-qm, Apo, AP 96205-0054 | 2006-08-31 |
| 1437160488 | Wanhee Choi | Military Health Care Provider | 18th Medcom, Attn:dccs-qm(credentials), Apo, AP 96205-0054 | 2006-08-11 |
| 1700843281 | Seung Wook Kim | Family Medicine | 18th Medcom, Attn: Dccs-qm (credentials), Apo, AP 96205-5244 | 2006-04-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518450394 | Charles D Walker | Nurse Practitioner | 0121 Md Hsp Combat Support, Apo, AP 96205 | 2018-06-07 |
| 1952815235 | Robert Martinusek | Physical Therapist | Brian Allgood Army Community Hospital Unit 15543, Bldg 7005, Apo, AP 96205 | 2017-11-26 |
| 1659897056 | Laura Tsu | Dentist | 618 Mc Co Dental Com Wbpdaa, Yong San, AP 96205 | 2017-08-17 |
| 1962959502 | Amy Lee Wooten | Nurse Anesthetist, Certified Registered | Brian Allgood Army Hospital, Unit 15244, Camp Humphreys, KOREA 96205 | 2016-09-01 |
| 1912451105 | Laurel Alison Kessler | Dentist | 618 Md Co Dental Company, Apo, AP 96205 | 2016-08-05 |
| 1396116059 | Stephanie Louise Wheeler | Counselor | Hq, Usameddac-korea, Unit 15281, Apo, AP 96205 | 2015-10-07 |
| 1720454994 | Jared Colin Stewart | Dentist | 618th Dental Company, Usa Dentac Korea, Unit 15652, Apo, AP 96205 | 2015-08-11 |
| 1356717524 | John Carmen Warren | Dentist | 618th Dental Company, Usa Dentac - Korea, Unit # 15652, Apo, AP 96205 | 2015-08-11 |
| 1912381823 | Chanise Garvin-dumay | Registered Nurse | 121 Csh/baach. Pad, Yongsan, Apo, AP 96205 | 2015-07-10 |
| 1245611854 | Sabrina Emerald Kunciw | Family Medicine | 121 Csh/baach, Building #17005, Apo, AP 96205 | 2015-06-10 |
| Find all providers in zip 96205 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962038661 | Maria Cecilia Canlas | Nurse Practitioner | Psc 444 Box #94, Apo, AP 96297-9998 | 2020-03-14 |
| 1639574023 | Chianti K Ivory | Nurse Practitioner | Psc 305 Box 746, Apo, AP 96218-0008 | 2014-10-28 |
| 1750781787 | Heather Ortiz | Nurse Practitioner | Psc 2 Box 1946, Apo, AP 96264-0020 | 2014-08-27 |
| 1689093239 | Audrey Jane Franks | Nurse Practitioner | Soldier Family Medical Center, Apo, AA 79925 | 2014-04-10 |
| 1720350697 | Jennifer B Hardin | Nurse Practitioner | B. Co. 4-2 Avn, Unit # 15712 Mailbox # 1022, Apo, AP 96271 | 2012-02-07 |
| 1043442247 | Christina M Carter | Nurse Practitioner | 18th Med Group Unit 5142, Apo, AP 96368 | 2009-08-20 |
| 1316177082 | Jean Folarin | Nurse Practitioner | U.S. Army Health Clinic Stuttgart, Unit 30401, Apo, AE 09107-0401 | 2009-07-16 |
| 1295933505 | Terrance D. Banen | Nurse Practitioner | Unit 64900 Box 19, Apo, AE 09839 | 2007-07-08 |
| 1265500847 | Ameurfinna Dimen Drake | Nurse Practitioner | 121st General Hospital 18th Medical Command, Unit 15281, Apo, AP 96205 | 2006-12-01 |
| 1508898628 | Cristina Rumbaoa Bagaymetcalf | Nurse Practitioner | Baumholder Health Clinic, Cmr 405, Apo, AE 09034 | 2006-07-07 |
| Find all providers in APO | ||||
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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.