TREVOR EDGINGTON (NPI# 1467984187) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467984187 |
| Entity Type | Individual |
| Full Name | TREVOR EDGINGTON |
| Credential | M.D. |
| Practice Address |
2200 Bergquist Dr Ste 1 Lackland Afb TX 78236-9908 |
| Mailing Address |
3551 Roger Brooke Dr Fort Sam Houston TX 78234-4504 |
| Practice Telephone | 2109168666 |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2018-11-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 31227 | NE | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
2200 BERGQUIST DR STE 1 |
| City | LACKLAND AFB |
| State | TX |
| Zip Code | 78236-9908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427041979 | Terence Gerald Benson Jr. | Pharmacist | 2200 Bergquist Dr Ste 1, Lackland Afb, TX 78236-9908 | 2005-08-30 |
| 1972031011 | George Benson | General Practice | 2200 Bergquist Dr Ste 1, Lackland Afb, TX 78236-9908 | 2017-06-02 |
| 1376938399 | Colette Poole-boykin | Student in an Organized Health Care Education/Training Program | 2200 Bergquist Dr Ste 1, Ste 1, Lackland Afb, TX 78236-9908 | 2015-04-06 |
| 1720210933 | John Ryan Brewer | Ophthalmology | 2200 Bergquist Dr Ste 1, Attn: Credentials (cmc), Lackland Afb, TX 78236-9908 | 2009-08-20 |
| 1023256815 | Risa Cavalcanti Riepma | Dietitian, Registered | 2200 Bergquist Dr Ste 1, Attn: Credentials (cmc), Lackland Afb, TX 78236-9908 | 2009-02-02 |
| 1073767117 | Susan Wright Mongeau | Dentist | 2200 Bergquist Dr Ste 1, Lackland Afb, TX 78236-9908 | 2008-11-14 |
| 1053571018 | Brian Michael Fitzgerald | Anesthesiology | 2200 Bergquist Dr Ste 1, Lackland Afb, TX 78236-9908 | 2008-06-12 |
| 1760649297 | Rayna Lane Wooten | Dietitian, Registered | 2200 Bergquist Dr Ste 1, Lackland Afb, TX 78236-9908 | 2008-05-21 |
| 1235309659 | Margaret Bonnie Cole | Pharmacist | 2200 Bergquist Dr Ste 1, Lackland Afb, TX 78236-9908 | 2008-03-03 |
| 1134397953 | Jean Rae Facchini | Dietitian, Registered | 2200 Bergquist Dr Ste 1, Attn: Credentials (cmc), Lackland Afb, TX 78236-9908 | 2008-02-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
| 1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
| 1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
| 1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
| 1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
| 1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
| 1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
| 1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
| 1376906958 | David Kephart Jr. | General Practice | 1100 Wilford Hall Loop Bldg 4454, Jbsa Lackland, TX 78236 | 2016-04-01 |
| 1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
| Find all providers in zip 78236 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346631876 | Christopher Jorgensen | General Practice | 2200 Bergquist Dr. Ste 1, Whasc/psychiatry - 59 Mhs/sgow, Lackland Afb, TX 78236-9908 | 2015-02-05 |
| 1114243128 | Eric Gerard Meyer II | General Practice | 2200 Bergquist Drive Ste 1, Whmc Psychiatry, Lackland Afb, TX 78236-9908 | 2010-04-15 |
| 1972031011 | George Benson | General Practice | 2200 Bergquist Dr Ste 1, Lackland Afb, TX 78236-9908 | 2017-06-02 |
| 1366855694 | William Dennis | General Practice | 1100 Wilford Hall Loop, Lackland Afb, TX 78236 | 2014-06-04 |
| 1922367242 | Alisa Anne Miller | General Practice | 2200 Bergquist Dr., Wilford Hall Amb Surgical Center, Lackland Afb, TX 78236-9908 | 2012-05-07 |
| 1427343920 | Alexis Anthon Beauvais | General Practice | 2200 Bergquist Drive, Wilford Hall Medical Center, Lackland Afb, TX 78263-9908 | 2011-06-13 |
| 1699064220 | Samuel Leathen Madson | General Practice | 1100 Wilford Hall Loop Bldg 4554, Lackland Afb, TX 78236-5638 | 2011-04-05 |
| 1326226200 | Manuel A Nunez | General Practice | 1515 Truemper St, Lackland Afb, TX 78236-5583 | 2008-02-04 |
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| Find all providers with the same taxonomy | ||||
| City | LACKLAND AFB |
| Zip Code | 78236 |
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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.