DR. COURTNEY ELLEN HALISTA (NPI# 1417337965) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417337965 |
| Entity Type | Individual |
| Full Name | DR. COURTNEY ELLEN HALISTA |
| Credential | M.D. |
| Practice Address |
101 Bodin Cir 60 Md/mdos Travis Afb CA 94535 |
| Mailing Address |
101 Bodin Cir 60 Md/mdos Travis Afb CA 94535-1809 |
| Practice Telephone | 7074233735 |
| Mailing Telephone | 7074233735 |
| Enumeration Date | 2015-05-30 |
| Last Update Date | 2018-07-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 29530 | NE | Allopathic & Osteopathic Physicians |
| Street Address |
101 BODIN CIR 60 MD/MDOS |
| City | TRAVIS AFB |
| State | CA |
| Zip Code | 94535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801893276 | Charles A Tujo | Radiology | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2005-06-30 |
| 1538769351 | Chelsey Violet Pelkey | Military Health Care Provider | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-10-30 |
| 1538768114 | Jordan Rose | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-10-23 |
| 1821606591 | Madelyn Hale | Military Health Care Provider | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-07-20 |
| 1932727856 | Julie Thein | Audiologist | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-07-07 |
| 1063039501 | Shae Daniel Bryant | Dentist | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-07-01 |
| 1598381089 | Aaron J Surbaugh | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-06-19 |
| 1194348466 | Amanda Vance | Registered Nurse | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-05-21 |
| 1427681196 | Bradley Burkey | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-02-20 |
| 1821629288 | Gloria Calvillo | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-02-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487711 | Sheila C Flood | Student in an Organized Health Care Education/Training Program | 101 Biden Circle, Fairfield, CA 94535 | 2020-04-28 |
| 1568081255 | Miguel Julian Moreno | Student in an Organized Health Care Education/Training Program | 690 Airmen Drive, Travis Afb, CA 94535 | 2020-04-13 |
| 1174096101 | Zlatoslava Karga | Nurse Practitioner | 60mdg / Sgow, 101 Bodin Circle, Travis Afb, CA 94535 | 2019-01-02 |
| 1437648292 | Luke C Vera | Dentist | David Grant Medical Center 101 Bodin Circle, Travis Air Force Base, CA 94535 | 2018-05-08 |
| 1588163430 | Sanaz Ziad | Pharmacist | 60mdg/mdts, 101 Bodin Circle, Travis Afb, CA 94535 | 2018-02-06 |
| 1194265686 | Geoffrey Johnston | Dentist | 60 Mdg/sgdd, 101 Bodin Circle, Travis Afb, CA 94535 | 2017-03-02 |
| 1336693407 | Hannah Isla Nordwall | Social Worker | 60 Mdg/mdos 101 Bodin Cir, Travis Afb, CA 94535 | 2016-08-06 |
| 1184177149 | Taylor Murrie-robinson | Social Worker | 60mdg / Sgow Mental Health Clinic, 101 Bodin Circle, Travis Afb, CA 94535 | 2016-07-26 |
| 1952759607 | Eric Kincaid-sharp | General Practice | 60 Mdg/amds, 101 Bodin Cir, Travis Afb, CA 94535 | 2016-06-02 |
| 1023472040 | Genieve Marie Martinez-hernandez | Internal Medicine | 60 Mdg/sgomi, 101 Bodin Circle, Fairfield, CA 94535 | 2016-04-06 |
| Find all providers in zip 94535 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932512746 | Stephen Larry Cook | Family Medicine | 60 Mdg/sgop, 101 Bodin Circle, Travis Afb, CA 94535 | 2014-06-09 |
| 1699113019 | Lauren Mitchell | Family Medicine | 60 Mdg/ Sgof, 101 Bodin Circle, Travis Afb, CA 94535-1800 | 2013-06-07 |
| 1235428889 | Lee Thomas Church | Family Medicine | 60mdg/sgof, 101 Bodin Cir, Travis Afb, CA 94535-1800 | 2011-04-05 |
| 1356412050 | David V Eastham | Family Medicine | 101 Bodin Circle, Sgqx, Dept of Radiation Oncology, Travis Afb, CA 94535 | 2006-11-13 |
| 1780796938 | An Thuy Duong | Family Medicine | 777 Bodin Circle, 2c 383, Travis Afb, CA 95687 | 2006-08-31 |
| 1912354721 | Kelliann Leli | Family Medicine | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2016-05-22 |
| 1326495441 | Jacob David Townsend | Family Medicine | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2016-05-18 |
| 1477900504 | Micah Bucy | Family Medicine | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2016-05-18 |
| 1356723191 | Glynnis Knobloch | Family Medicine | 101 Bodin Cir, Travis Afb, CA 94535 | 2015-06-28 |
| 1790167203 | Robert J Caulkins | Family Medicine | 101 Bodin Cir, Travis Afb, CA 94535 | 2015-06-19 |
| Find all providers in TRAVIS AFB | ||||
| City | TRAVIS AFB |
| Zip Code | 94535 |
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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.