STEPHON PEYTON FROST


Address: 2654 Mendonca Dr, San Diego, CA 92110-4263
Phone: 5189616153

STEPHON PEYTON FROST (NPI# 1255943635) 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) 1255943635
Entity Type Individual
Full Name STEPHON PEYTON FROST
Credential SFIDC
Practice Address 2654 Mendonca Dr
San Diego
CA 92110-4263
Practice Telephone 5189616153
Mailing Telephone 5189616153
Enumeration Date 2020-08-18
Last Update Date 2020-08-18
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 2654 MENDONCA DR
City SAN DIEGO
State CA
Zip Code 92110-4263

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1427539048 Allison Turrell Case Manager/Care Coordinator 4930 Naples Street, San Diego, CA 92110 2018-08-22
1750872768 Matthew Langworthy Physical Therapist 3405 Kenyon St Ste 212, San Diego, CA 92110 2018-05-24
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1437670155 Monique A Fernandez Counselor 3132 Jefferson Street, San Diego, CA 92110 2017-07-03
1538510391 Mayu Winters Registered Nurse 853 Rosecrans St, San Diego, CA 92110 2016-06-23
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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
1770180648 Darius Lee Sean Woods Military Health Care Provider 6033 Sandy Shore Ct, San Diego, CA 92139-1014 2020-10-05
1174130744 Daniel Carrera Military Health Care Provider 2645 W Canyon Ave Apt 450, San Diego, CA 92123-4700 2020-09-28
1316551740 Kyle Bode Francis Military Health Care Provider 3149 Murray Ridge Rd, San Diego, CA 92123-2917 2020-09-02
1255945069 Jeremy Lee Military Health Care Provider 509 Dennery Rd Apt 145, San Diego, CA 92154-8542 2020-08-31
1013520667 Rashaad Brown Military Health Care Provider 4454 Cherokee Ave Apt 2, San Diego, CA 92116-3611 2020-08-24
1932711934 Alvaro Daniel Macias Military Health Care Provider 8685 Rio San Diego Dr Apt 4344, San Diego, CA 92108-6560 2020-08-20
1689286189 Charles Luke Morris Military Health Care Provider 1675 Beta Ct, San Diego, CA 92126-7060 2020-08-18
1184235871 Jaden Sandi Military Health Care Provider Swmi Sfidc Bldg 14 34101 Farenholt Ave, San Diego, CA 92134-0001 2020-08-14
1477178457 Joseph Hunter Sampson Military Health Care Provider 34101 Farenholt Ave #14, San Diego, CA 92134 2020-06-15
1639794829 Joshua Day Henderson Military Health Care Provider 4633 Bancroft St Apt 3, San Diego, CA 92116-3338 2020-06-12
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Competitor

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City SAN DIEGO
Zip Code 92110

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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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