JEFFERY D STOCKWELL (NPI# 1407957418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407957418 |
| Entity Type | Individual |
| Full Name | JEFFERY D STOCKWELL |
| Credential | N.P. |
| Practice Address |
2615 Fairway St Dickinson ND 58601-2590 |
| Mailing Address |
202 Prospect Dr Glendive MT 59330-1943 |
| Practice Telephone | 7014566000 |
| Mailing Telephone | 4063453314 |
| Mailing Fax Number | 4063453324 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2018-10-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
25328 | MT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R27770 | ND | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 19836 | 05 | |
| MT | 4307550 | 05 | |
| MEDICARE RAIL ROAD | P00298214 | 01 | |
| MT | BLUE CROSS/BLUE SHIELD MT | 370061 | 01 |
| FEDERAL BLUE CROSS | 370061 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 202 Prospect Dr, Glendive, MT 593301943 | 4063453314 | 4063453324 |
| Street Address |
2615 FAIRWAY ST |
| City | DICKINSON |
| State | ND |
| Zip Code | 58601-2590 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649240557 | Clark J Fullmer II | Podiatrist | 2615 Fairway St, Dickinson, ND 58601 | 2006-01-24 |
| 1295369882 | Nicolette Lyn Tippett | Registered Nurse | 2615 Fairway St, Dickinson, ND 58601-2590 | 2020-02-24 |
| 1295365484 | Daniel Kuske | Physician Assistant | 2615 Fairway St, Dickinson, ND 58601-2590 | 2020-01-16 |
| 1194362111 | Joann Marie Nupen Lindemann | Nurse Practitioner | 2615 Fairway St, Dickinson, ND 58601-2590 | 2019-12-10 |
| 1699256537 | Michael Miller | Physical Therapist | 2615 Fairway St, Dickinson, ND 58601-2590 | 2018-08-28 |
| 1932607439 | Jessica Schneider | Pharmacist | 2615 Fairway St, Dickinson, ND 58601 | 2018-01-30 |
| 1699296277 | Anna Jade Newby | Nurse Practitioner | 2615 Fairway St, Dickinson, ND 58601-2590 | 2017-07-04 |
| 1497275572 | Kristine Nicole Gayda | Nurse Practitioner | 2615 Fairway St, Dickinson, ND 58601 | 2017-06-21 |
| 1255871752 | Allison Browning | Student in an Organized Health Care Education/Training Program | 2615 Fairway St, Dickinson, ND 58601-2590 | 2017-03-02 |
| 1548702632 | Colin Hulm | Specialist/Technologist | 2615 Fairway St, Dickinson, ND 58601-2590 | 2016-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679171235 | Able Inc | Community/Behavioral Health | 1951 1st Street West, Dickinson, ND 58601 | 2020-10-15 |
| 1922626456 | Tess R Johnson, Pllc | Clinic/Center | 579 River Drive, Dickinson, ND 58601 | 2020-07-10 |
| 1295367449 | Winds of Change Counseling Services LLC | Psychologist | 30 7th St. W, Door A, Dickinson, ND 58601 | 2020-02-05 |
| 1588194351 | Nancy Wanner | Case Manager/Care Coordinator | 135 Sims Street, Suite 208, Dickinson, ND 58601 | 2017-06-14 |
| 1518332352 | Chi St. Joseph's Hospital | General Acute Care Hospital | 2500 Fairway St., Dickinson, ND 58601 | 2015-12-04 |
| 1205200359 | Jenna Weisz | Occupational Therapist | 870 Pheasant Run Ave, Dickinson, ND 58601 | 2015-11-29 |
| 1609243450 | Little Missouri Chiropractic, LLC | Chiropractor | 1462 1-94 Business Loop East, Dickinson, ND 58601 | 2015-08-27 |
| 1053799320 | Lisette Michaels | Speech-Language Pathologist | 683 State Ave N, Dickinson, ND 58601 | 2015-05-07 |
| 1336548221 | Neal Steiner | Pharmacist | 352c 1st St E, Dickinson, ND 58601 | 2014-08-18 |
| 1841607793 | Isaac Akinola | Pharmacist | 1681 Third Ave W., Dickinson, ND 58601 | 2014-07-11 |
| Find all providers in zip 58601 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013407162 | Taryone Elaine Bernstine | Nurse Practitioner | 1728 N Meridian Greens Dr, Dickinson, TX 77539-8369 | 2018-05-15 |
| 1063682177 | Carol A Reyes | Nurse Practitioner | 4909 Blue Water Ln, Dickinson, TX 77539-6501 | 2008-03-04 |
| 1497372965 | Deann Schaefer | Nurse Practitioner | 2500 Fairway St, Dickinson, ND 58601-2639 | 2020-07-01 |
| 1194362111 | Joann Marie Nupen Lindemann | Nurse Practitioner | 2615 Fairway St, Dickinson, ND 58601-2590 | 2019-12-10 |
| 1447897038 | Dana Marie Glasser | Nurse Practitioner | 2500 Fairway St, Dickinson, ND 58601-2639 | 2019-12-03 |
| 1033752530 | Crystal Jean Sullivan | Nurse Practitioner | 2500 Fairway St, Dickinson, ND 58601-2639 | 2019-10-28 |
| 1306495072 | Amy Guzman | Nurse Practitioner | 2500 Fairway St, Dickinson, ND 58601-2639 | 2019-09-05 |
| 1235643164 | Beatrice Cheruiyot | Nurse Practitioner | 646 Fm 517 Rd W, Dickinson, TX 77539-3904 | 2017-11-30 |
| 1144730573 | Diane Jennifer Rosaly | Nurse Practitioner | 676 Fm 517 Rd W, Dickinson, TX 77539-3904 | 2017-10-12 |
| 1699296277 | Anna Jade Newby | Nurse Practitioner | 2615 Fairway St, Dickinson, ND 58601-2590 | 2017-07-04 |
| Find all providers in DICKINSON | ||||
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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.