DAVID PATCH (NPI# 1134536881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134536881 |
| Entity Type | Individual |
| Full Name | DAVID PATCH |
| Credential | ATC, MED |
| Practice Address |
Pediatric Residency Program, Memorial University Medical Center 4700 Waters Avenue Savannah GA 31404 |
| Practice Telephone | 9123508193 |
| Mailing Telephone | 9123508193 |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2019-04-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
2000009788 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | N/A | 1134536881 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 107 Trillium Ter, Macon, GA 312108021 | 4787181804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740787407 | David Bradley Patch | Student in an Organized Health Care Education/Training Program | University of Utah Hospital Dental Clinic #7, 50 N. Medical Dr., Salt Lake City, UT 84112 | 2018-04-10 |
| 1356859813 | David Lee Patch | Chiropractor | 3430 Towne Pointe Dr, Bettendorf, IA 52722-5320 | 2018-01-18 |
| 1821258625 | David Alan Patch Jr. | Counselor | 222 Saint John St, Suite 210, Portland, ME 04102-3000 | 2008-06-15 |
| Street Address |
PEDIATRIC RESIDENCY PROGRAM, MEMORIAL UNIVERSITY MEDICAL CENTER 4700 WATERS AVENUE |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043864580 | Carli A Boatright | Registered Nurse | 4750 Waters Ave Suite 206, Savannah, GA 31404 | 2019-08-01 |
| 1619530573 | Morgan Johnson | Student in an Organized Health Care Education/Training Program | Memorial Health University Medical Center, 4700 Waters Ave, Savannah, GA 31404 | 2019-04-17 |
| 1477050243 | Kevin Timperman | Student in an Organized Health Care Education/Training Program | 4700 Waters Avenus, Surgery Residency Program, Mhumc, Savannah, GA 31404 | 2018-04-09 |
| 1376048959 | Nina Jo Paletta | Student in an Organized Health Care Education/Training Program | Memorial University Medical Center, 4700 Waters Ave., Savannah, GA 31404 | 2018-03-27 |
| 1972036200 | Jose Adrian Lara Gonzalez | Student in an Organized Health Care Education/Training Program | 4700 Waters Ave, Memorial University Medical Center, Internal Medicine Residency Program, Savannah, GA 31404 | 2017-04-04 |
| 1407210396 | Lexie Hester Vaughn | Student in an Organized Health Care Education/Training Program | 1250 East 66th St, Savannah, GA 31404 | 2016-04-07 |
| 1336503291 | Miles Love | Student in an Organized Health Care Education/Training Program | 1250 East 66th Street, Savannah, GA 31404 | 2016-04-07 |
| 1962846683 | Alan Danilo Zevallos | Internal Medicine | 4700 Waters Avenue, University Medical Center, Internal Medicine Residency Program, Memorial Health, Savannah, GA 31404 | 2013-04-24 |
| 1730446394 | Joshua Ryan Fann | Prosthetist | 3840 Waters Ave, Savannah, GA 31404 | 2012-04-19 |
| 1922270941 | Tyneise Seaborough | Occupational Therapist | 508 Atkinson Ave, Savannah, GA 31404 | 2008-03-31 |
| Find all providers in zip 31404 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962042556 | Pooja Vinay Patel | Student in an Organized Health Care Education/Training Program | 1 Harvest Ln, Savannah, GA 31411-2116 | 2020-01-10 |
| 1619530573 | Morgan Johnson | Student in an Organized Health Care Education/Training Program | Memorial Health University Medical Center, 4700 Waters Ave, Savannah, GA 31404 | 2019-04-17 |
| 1629541818 | Brittany Sue Walker | Student in an Organized Health Care Education/Training Program | 10 Rivermist Ln, Savannah, GA 31410-2524 | 2019-01-10 |
| 1548737786 | John Thomas Muller | Student in an Organized Health Care Education/Training Program | 120 Brompton Rd, Savannah, GA 31410-3183 | 2018-10-25 |
| 1477050243 | Kevin Timperman | Student in an Organized Health Care Education/Training Program | 4700 Waters Avenus, Surgery Residency Program, Mhumc, Savannah, GA 31404 | 2018-04-09 |
| 1376048959 | Nina Jo Paletta | Student in an Organized Health Care Education/Training Program | Memorial University Medical Center, 4700 Waters Ave., Savannah, GA 31404 | 2018-03-27 |
| 1043718877 | Alexa Coscia | Student in an Organized Health Care Education/Training Program | 505 Mall Blvd Apt 103, Savannah, GA 31406-4855 | 2018-01-26 |
| 1093240343 | Kimberly Tarver | Student in an Organized Health Care Education/Training Program | 4200 Waters Ave, Savannah, GA 31404-6214 | 2017-04-25 |
| 1972036200 | Jose Adrian Lara Gonzalez | Student in an Organized Health Care Education/Training Program | 4700 Waters Ave, Memorial University Medical Center, Internal Medicine Residency Program, Savannah, GA 31404 | 2017-04-04 |
| 1407210396 | Lexie Hester Vaughn | Student in an Organized Health Care Education/Training Program | 1250 East 66th St, Savannah, GA 31404 | 2016-04-07 |
| Find all providers in SAVANNAH | ||||
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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.