MR. TIMOTHY AARON GUNDLACH (NPI# 1285872457) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285872457 |
| Entity Type | Individual |
| Full Name | MR. TIMOTHY AARON GUNDLACH |
| Credential | PA-C |
| Practice Address |
1936 Tibbetstown Dr Virginia Beach VA 23454-6743 |
| Mailing Address |
4746 Pico St. San Diego CA 92109 |
| Practice Telephone | 7573019715 |
| Mailing Telephone | 7608772725 |
| Enumeration Date | 2009-01-27 |
| Last Update Date | 2011-11-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144200205 | Timothy Erik Gundlach | Anesthesiology | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2006-01-17 |
| Street Address |
1936 TIBBETSTOWN DR |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23454-6743 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356994263 | Agape Consulting | Behavioral Analyst | 1216 Garth Court, Virginia Beach, VA 23454 | 2019-07-19 |
| 1831650266 | Amelia Jo Crutsinger | Physician Assistant | 1644 Kepler Bnd, Virginia Beach, VA 23454 | 2019-03-28 |
| 1538639158 | Bay Psychiatric II Inc | Counselor | 923 First Colonial Rd Suite 1821, Virginia Beach, VA 23454 | 2018-11-26 |
| 1487151759 | Akanksha Mohan | Student in an Organized Health Care Education/Training Program | 100 Mannng Drive, Chapel Hill, Nc 27514, Chapel Hill, NC 23454 | 2018-04-12 |
| 1275038580 | Food Lion, LLC | Durable Medical Equipment & Medical Supplies | 1615 General Booth Blvd, Virginia Beach, VA 23454 | 2018-03-28 |
| 1346783164 | Tracy Chasse | Occupational Therapy Assistant | 1628 Old Donation Parkway, Virginia Beach, VA 23454 | 2016-11-28 |
| 1982066627 | Jennifer Mitchell | Speech-Language Pathologist | 2101 Agecroft Rd., Virginia Beach, VA 23454 | 2016-03-22 |
| 1659730562 | Rebecca Houvener | Psychologist | 1120 First Colonial Rd Ste 202, Virginia Beach, VA 23454 | 2016-02-19 |
| 1932581741 | Monica Jane Bailey | Nurse Practitioner | 2110 N Great Neck Rd, Virginia Beach, VA 23454 | 2015-06-29 |
| 1376930073 | Ashley A Burkholder | Family Medicine | 1024 First Colonial Rd Ste 104, Virginia Beach, VA 23454 | 2015-04-20 |
| Find all providers in zip 23454 | ||||
| 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 | 23454 |
Please comment or provide details below to improve the information on MR. TIMOTHY AARON GUNDLACH.
| 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.