MR. ELLIOTT SPENCER KECK (NPI# 1255536785) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255536785 |
| Entity Type | Individual |
| Full Name | MR. ELLIOTT SPENCER KECK |
| Credential | IDC |
| Practice Address |
1550 Tomcat Blvd Ste 150 Nas Oceana, Bhc Virginia Beach VA 23460-2186 |
| Practice Telephone | 7579533792 |
| Mailing Telephone | 7579533792 |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2012-07-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 247200000X | Technician, Other | Technologists, Technicians & Other Technical Service Providers | ||
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| Street Address |
1550 TOMCAT BLVD STE 150 NAS OCEANA, BHC |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23460-2186 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659341105 | Kevin Eugene Brooks | Preventive Medicine | 1550 Tomcat Blvd Ste 150, Branch Health Clinic Oceana, Virginia Beach, VA 23460-2186 | 2006-01-26 |
| 1033658976 | Melissa Harbert | Pharmacist | 1550 Tomcat Blvd Ste 150, Virginia Beach, VA 23460-2188 | 2017-02-13 |
| 1174066773 | Jeffrey Walker | Physician Assistant | 1550 Tomcat Blvd Ste 150, Virginia Beach, VA 23460-2188 | 2016-11-30 |
| 1205285830 | Kyle Mcdonald | Family Medicine | 1550 Tomcat Blvd Ste 150, Virginia Beach, VA 23460 | 2016-06-04 |
| 1245613140 | Aimee Elizabeth Dinwiddie | Physician Assistant | 1550 Tomcat Blvd Ste 150, Virginia Beach, VA 23460-2186 | 2015-07-09 |
| 1255724761 | Natalie Elizabeth Slepski | General Practice | 1550 Tomcat Blvd Ste 150, Virginia Beach, VA 23460-2188 | 2015-03-08 |
| 1578977666 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 1550 Tomcat Blvd Ste 150, Naval Air Station Oceana, Virginia Beach, VA 23460-2186 | 2014-06-17 |
| 1194032748 | Derek Lee Deboer | General Practice | 1550 Tomcat Blvd Ste 150, Virginia Beach, VA 23460-2186 | 2010-09-02 |
| 1750543898 | Larry Jason Flint | Military Health Care Provider | 1550 Tomcat Blvd Ste 150, Virginia Beach, VA 23460-2186 | 2008-06-30 |
| 1407022544 | Eduardo Linares | Physician Assistant | 1550 Tomcat Blvd Ste 150, Branch Health Clinic - Naval Air Station Oceana, Virginia Beach, VA 23460-2186 | 2008-05-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619400249 | Michael Alexander Sumner | General Practice | Nas Oceana Branch Medical Clinic, 1640 Tomcat Blvd, Virginia Beach, VA 23460 | 2017-04-10 |
| 1649255969 | Amarjeet Singh Purewal | Psychologist | 1550 Tomcat Blvd, Virginia Beach, VA 23460 | 2005-12-09 |
| 1578593943 | Paul John Averell | Clinic/Center | 1550 Tomcat Blvd, Virginia Beach, VA 23460 | 2006-07-03 |
| 1902876113 | Christine Renee Norris | Pharmacist | 1550 Tomcat Blvd, Virginia Beach, VA 23460 | 2006-01-23 |
| 1679980767 | Lauren Collins Ervin Brown | Dentist | 1750 Tomcat Blvd Bldg 285, Virginia Beach, VA 23460-2168 | 2014-07-21 |
| 1588935829 | Heather Sterling Slusser | General Practice | 1750 Tomcat Blvd, Branch Medical Clinic Oceana, Virginia Beach, VA 23460-2168 | 2012-01-18 |
| 1184259921 | Mellie Rose Vann | Pharmacist | 1750 Tomcat Blvd, Virginia Beach, VA 23460-2168 | 2020-03-11 |
| 1497245765 | John Vietquang Dang | Student in an Organized Health Care Education/Training Program | 1750 Tomcat Blvd, Virginia Beach, VA 23460-2168 | 2018-05-13 |
| 1366940314 | Kyle Alan Bement | Student in an Organized Health Care Education/Training Program | 1750 Tomcat Blvd, Virginia Beach, VA 23460-2168 | 2018-01-24 |
| 1629418017 | Matthew Joseph Carr | General Practice | 1750 Tomcat Blvd, Virginia Beach, VA 23460-2168 | 2013-06-28 |
| Find all providers in zip 23460 | ||||
| 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 |
|---|---|---|---|---|
| 1306455522 | Kevin Bradley | Military Health Care Provider | 903 13th St, Virginia Beach, VA 23451-4476 | 2020-07-23 |
| 1851900088 | Seth Walter | Military Health Care Provider | 1825 Olympic Dr, Virginia Beach, VA 23453-3720 | 2020-07-23 |
| 1912545534 | Ashton Neal Burnett | Military Health Care Provider | 1875 Cove Rd Bldg 3806, Virginia Beach, VA 23459-8911 | 2019-12-13 |
| 1578056743 | Elis Bojaxhi | Military Health Care Provider | 3044 Ashlawn Ter, Virginia Beach, VA 23452-6508 | 2018-06-12 |
| 1497298616 | Mario Zavala | Military Health Care Provider | 408 N Amsterdam Ct, Virginia Beach, VA 23454-4213 | 2016-11-19 |
| 1568904738 | Pierce Cogburn | Military Health Care Provider | 3985 Old Forge Rd, Virginia Beach, VA 23452-2173 | 2016-11-04 |
| 1851841449 | John Douglas Moore | Military Health Care Provider | 1004 Hermitage Rd Bldg 1014, Virginia Beach, VA 23459-9100 | 2016-10-07 |
| 1730559618 | Aaron Joseph Cortina | Military Health Care Provider | 2340 Amphibious Dr, Bldg 2012 Suite 125, Virginia Beach, VA 23459-8810 | 2015-10-05 |
| 1427430297 | Daniel Anthony Leonesio | Military Health Care Provider | 1432 Pandoria Ct, Virginia Beach, VA 23455-3738 | 2015-06-29 |
| 1346659570 | Nicholas Charles Edward Rohde | Military Health Care Provider | 4946 Juno Rd, Virginia Beach, VA 23455-2244 | 2014-08-13 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23460 |
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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.