KENNETH PERRY VANTASSEL


Address: 1410 Woodfair Dr, Richmond, TX 77406-6609
Phone: 5306513022

KENNETH PERRY VANTASSEL (NPI# 1225581481) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1225581481
Entity Type Individual
Full Name KENNETH PERRY VANTASSEL
Practice Address 1410 Woodfair Dr
Richmond
TX 77406-6609
Practice Telephone 5306513022
Enumeration Date 2016-07-24
Last Update Date 2016-07-24
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1710I1002X Military Health Care Provider
Specialization: Independent Duty Corpsman
Other Service Providers

Office Location

Street Address 1410 WOODFAIR DR
City RICHMOND
State TX
Zip Code 77406-6609

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Taxonomy Information

Taxonomy Code 1710I1002X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Corpsman

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1164779591 Christian Thomsen Military Health Care Provider 2510 Camelback Road, Richmond, VA 23236 2012-08-03

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1528430980 Tomasz Orent Military Health Care Provider 26885 Manor Falls Dr, Kingwood, TX 77339-7709 2015-10-26
1518337013 John Cantu Military Health Care Provider 3945 Tripoli Dr, Corpus Christi, TX 78415-3348 2015-09-28
1699144428 Alberto Gonzalez Military Health Care Provider 102 Redrock Dr, San Antonio, TX 78213-4526 2015-09-22
1275938375 Ricardo Jaramillo Military Health Care Provider 7016 Austrian Pine, Brownsville, TX 78526 2014-10-31
1942637087 Matthew Alan Robichaux Military Health Care Provider 13500 White Tail Trl, Austin, TX 78736-7422 2013-10-03
1417223710 Adam Anthony Garcia Military Health Care Provider 12080 Paseo De Amor Ln, El Paso, TX 79936-4499 2012-03-30
1124306329 David G Morales Jr. Military Health Care Provider 9180 Tenango Dr, El Paso, TX 79907-3257 2011-07-22
1689970535 Michael G. Phillips Military Health Care Provider 2621 Las Brisas St, Corpus Christi, TX 78414-5014 2011-02-09
1912208216 Shepley Allen Reimer Military Health Care Provider 3555 Patch Rd, Fort Sam Houston, TX 78234-1200 2010-11-03
1750690400 John Douglas Compton Jr. Military Health Care Provider 13506 Wood Terrace Dr, Houston, TX 77038-1533 2010-09-29
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Competitor

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City RICHMOND
Zip Code 77406

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Dataset Information

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.

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