PHILLIP CONWELL (NPI# 1255540340) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255540340 |
| Entity Type | Individual |
| Full Name | PHILLIP CONWELL |
| Credential | CRNA |
| Practice Address |
700 River Dr Fort Bragg CA 95437-5403 |
| Mailing Address |
Po Box 34120 Reno NV 89533-4120 |
| Practice Telephone | 7079611234 |
| Mailing Telephone | 7757475050 |
| Mailing Fax Number | 7757475005 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163W00000X | Registered Nurse | RN405621 | CA | Nursing Service Providers |
| Street Address |
700 RIVER DR |
| City | FORT BRAGG |
| State | CA |
| Zip Code | 95437-5403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306896428 | John A Kermen | Anesthesiology | 700 River Dr, Fort Bragg, CA 95437-5403 | 2006-05-11 |
| 1710336300 | Glass Beach Medical Services A Medical Corporation | Emergency Medicine | 700 River Dr, Fort Bragg, CA 95437-5403 | 2016-06-06 |
| 1447585245 | Mark David Levine Md, Fort Bragg Professional Corporation | Psychiatry & Neurology | 700 River Dr, Fort Bragg, CA 95437-5403 | 2009-10-12 |
| 1962666313 | Donald Sheffel, M.d. | Surgery | 700 River Dr, Fort Bragg, CA 95437-5403 | 2008-07-15 |
| 1891982351 | Lois Faith Leister | Pharmacist | 700 River Dr, Mendocino Coast District Hospital Pharmacy, Fort Bragg, CA 95437-5403 | 2007-09-28 |
| 1659562742 | Marilyn Magoffin | Nurse Practitioner | 700 River Dr, Fort Bragg, CA 95437-5403 | 2007-08-05 |
| 1013060516 | Stephen Pinsk, M.d., Inc. | Clinical Medical Laboratory | 700 River Dr, Fort Bragg, CA 95437-5403 | 2007-01-19 |
| 1912079294 | Prakash P Devaskar | Pediatrics | 700 River Dr, Fort Bragg, CA 95437-5403 | 2006-11-14 |
| 1477641686 | Tamaki A. Myers | Emergency Medicine | 700 River Dr, Fort Bragg, CA 95437-5403 | 2006-10-11 |
| 1366535890 | Andrea Mccullough | Emergency Medicine | 700 River Dr, Fort Bragg, CA 95437-5403 | 2006-10-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902357437 | Mendocino Coast Hospitality Center | Community/Behavioral Health | 137 E. Oak Street, Fort Bragg, CA 95437 | 2016-10-19 |
| 1144604570 | Erin Paul | Community Health Worker | 474 South Franklin Street, Fort Bragg, CA 95437 | 2015-07-15 |
| 1508125790 | Joel Macgregor Green | Marriage & Family Therapist | 331- G Redwood Ave., Fort Bragg, CA 95437 | 2012-05-09 |
| 1013244102 | Jenna Glasscock | Counselor | 331 E Redwood Ave, Ste E, Fort Bragg, CA 95437 | 2009-11-10 |
| 1770819641 | Patrick Lenaghan | Emergency Medicine | 707 River Dr, Fort Bragg, CA 95437 | 2009-10-27 |
| 1043455827 | M. Lee Baker | Dentist | 890 River Dr, Fort Bragg, CA 95437 | 2008-12-09 |
| 1528250495 | Christine Anne Samas | Social Worker | 656a Harrison St., Fort Bragg, CA 95437 | 2007-08-15 |
| 1083822811 | Katharine L. White | Marriage & Family Therapist | 137 E Oak Street, Fort Bragg, CA 95437 | 2007-05-17 |
| 1053525873 | Marty Christine Johnson | Marriage & Family Therapist | 331 E. Redwood Ave, Fort Bragg, CA 95437 | 2007-05-10 |
| 1528114741 | Kate Teresa Donohue | Psychologist | 19201 Noyo Acres Dr, Fort Bragg, CA 95437 | 2007-01-29 |
| Find all providers in zip 95437 | ||||
| Taxonomy Code | 163W00000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.’s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span. |
| Notes: Sources: (2) American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053933291 | Maureen Smyth | Registered Nurse | 1025 E Chestnut St, Fort Bragg, CA 95437-5004 | 2020-05-11 |
| 1649707357 | Brynne Michelle Coaker | Registered Nurse | 2817 Reilly Rd., Fort Bragg, NC 28310-7324 | 2017-05-12 |
| 1215121025 | Angela Denice Imes | Registered Nurse | Medical One Stop Room 12, Normandy Drive, Fort Bragg, NC 28310-0001 | 2007-09-05 |
| 1487284980 | John Clarendon Worthington | Registered Nurse | 546 S Main St, Fort Bragg, CA 95437-5107 | 2020-01-23 |
| 1710338900 | Yvette Beard | Registered Nurse | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2016-06-29 |
| 1356727614 | William Townsend | Registered Nurse | 2817 Reilly St, Fort Bragg, NC 28310-4613 | 2015-08-09 |
| 1144550740 | Glenn Curtis Simpson IIi | Registered Nurse | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2010-01-04 |
| 1972831493 | Glenda Sue Wolfe | Registered Nurse | Wamc Stop A, Building 2817 Reilly Rd. Mcxc Cod Cs Credentials, Fort Bragg, NC 28310-0001 | 2009-11-20 |
| 1386977767 | Jennifer Salyer | Registered Nurse | 855 Sequoia Cir, Fort Bragg, CA 95437-5466 | 2009-09-16 |
| 1427222538 | Jenna Rose Breton | Registered Nurse | 855 Sequoia Cir, Fort Bragg, CA 95437 | 2008-04-18 |
| Find all providers in FORT BRAGG | ||||
| City | FORT BRAGG |
| Zip Code | 95437 |
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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.