CCN MEDICAL SERVICES LLC (NPI# 1518396589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518396589 |
| Entity Type | Organization |
| Organization Name | CCN MEDICAL SERVICES LLC |
| Practice Address |
1901 Babcock Rd Suite 102 San Antonio TX 78229-4554 |
| Mailing Address |
Po Box 320 Bulverde TX 78163-0320 |
| Practice Telephone | 2106086213 |
| Practice Fax Number | 2105192939 |
| Mailing Telephone | 2106086213 |
| Mailing Fax Number | 2105192939 |
| Enumeration Date | 2013-11-11 |
| Last Update Date | 2016-09-01 |
| Authorized Official Name | CHARLOTTE D BALLARD (PRESIDENT) |
| Authorized Official Telephone | 2106086213 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers | ||
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 329924001 | 05 |
| Street Address |
1901 BABCOCK RD SUITE 102 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78229-4554 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568468791 | Patrick F. Glasow | Pediatrics | 1901 Babcock Rd, Suite 301, San Antonio, TX 78229-4554 | 2005-06-22 |
| 1205468683 | Southlake Bnpt Investment LLC | Clinic/Center | 1901 Babcock Rd, San Antonio, TX 78229-4554 | 2020-02-04 |
| 1811444698 | Michelle Marie Marshall | Counselor | 1901 Babcock Rd, Ste. 102, San Antonio, TX 78229-4554 | 2016-09-08 |
| 1942682869 | Wound Care and Limb Salvage Specialty Group | Preventive Medicine | 1901 Babcock Rd, Suite 200, San Antonio, TX 78229-4554 | 2015-06-27 |
| 1811255714 | Phillip Harrison | Prosthetist | 1901 Babcock Rd, San Antonio, TX 78229-4554 | 2012-04-27 |
| 1184903866 | Carrie M. Hanaoka | Physical Therapy Assistant | 1901 Babcock Rd, Suite 304, San Antonio, TX 78229-4554 | 2011-08-11 |
| 1376871004 | Jessika Marie Garcia | Physical Therapist | 1901 Babcock Rd, Suite 204, San Antonio, TX 78229-4554 | 2009-11-18 |
| 1932366838 | Forte Physical Therapy | Clinic/Center | 1901 Babcock Rd, Suite 204, San Antonio, TX 78229-4554 | 2008-05-19 |
| 1508030248 | Kevin D Scott | Dentist | 1901 Babcock Rd, Suite 101, San Antonio, TX 78229-4554 | 2008-04-14 |
| 1952582074 | Christopher L Curzon | Pediatrics | 1901 Babcock Rd, Suite 301, San Antonio, TX 78229-4554 | 2007-11-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245857226 | Lyndsey A Sandoval | Optometrist | 7400 Minton Miner St, San Antonio, TX 78229 | 2020-06-25 |
| 1295355311 | Nicolet Finger | Student in an Organized Health Care Education/Training Program | 7703 Floyd Curl Drive, Mc 7798, San Antonio, TX 78229 | 2020-04-18 |
| 1215557400 | Amy Elizabeth Werry | Clinical Neuropsychologist | 7703 Floyd Circle Drive, San Antonio, TX 78229 | 2020-04-17 |
| 1740822972 | Mohammad Safaie Yazdi | Student in an Organized Health Care Education/Training Program | Ut Health Science Center At San Antonio- Agdc, 8210 Floyd Curl Dr., Msc 8103, San Antonio, TX 78229 | 2019-10-09 |
| 1063053072 | Blas Edward Villa | Nurse Practitioner | 7703 Floyd Curl Drive Mc 7885 Pulmonary Diseases & Crit, Medicine, San Antonio, TX 78229 | 2019-10-01 |
| 1124673942 | Integrity Dme Services LLC | Durable Medical Equipment & Medical Supplies | 6323 Sovereign Dr, Suite # 170 Ab, San Antonio, TX 78229 | 2019-08-08 |
| 1730734120 | Marisa Erin Leyden | Speech-Language Pathologist | Joe R. & Teresa Lozano Long Campus, 7703 Floyd Curl Dr., San Antonio, TX 78229 | 2019-08-03 |
| 1285295741 | Alireza Ghezavati | Student in an Organized Health Care Education/Training Program | 7703 Floyd Curl Drive Mc 7750, Department of Pathology and Laboratory Medicine, San Antonio, TX 78229 | 2019-06-25 |
| 1407410285 | Denae Cheyenne Rushing | Student in an Organized Health Care Education/Training Program | 8201 Floyd Curl Drive, San Antonio, TX 78229 | 2019-04-26 |
| 1265993570 | Shehzad Amlani | Student in an Organized Health Care Education/Training Program | Address: 7703 Floyd Curl Dr, San Antonio, TX 78229 | 2019-03-28 |
| Find all providers in zip 78229 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184224834 | Natasha Bakunda | Nurse Practitioner | Fountainhead One Tower, 8200 Ih-10 West, Ste 317, San Antonio, TX 78230 | 2020-10-30 |
| 1033719521 | Macy Atkins | Nurse Practitioner | 6676 Utsa Blvd, San Antonio, TX 78249-5100 | 2020-10-26 |
| 1801494554 | Yordanis Rafael Fonseca Vega | Nurse Practitioner | 12521 Nacogdoches Rd Ste 101, San Antonio, TX 78217-2117 | 2020-10-14 |
| 1255939237 | Ashley Elizabeth Swartz | Nurse Practitioner | 9502 Huebner Rd Ste 101, San Antonio, TX 78240-1683 | 2020-10-13 |
| 1871190173 | Cynthia B Elkins | Nurse Practitioner | 24806 Terlingua Bnd, San Antonio, TX 78261-2726 | 2020-10-08 |
| 1588270623 | Amanda Razo | Nurse Practitioner | 6315 Welles Arbor Cir, San Antonio, TX 78240-2148 | 2020-09-23 |
| 1255946935 | Norberto Hernandez Iv | Nurse Practitioner | 11501 Braesview Apt 3903, San Antonio, TX 78213-1262 | 2020-09-10 |
| 1033723655 | Hira Mughal | Nurse Practitioner | 9850 Twinbear Crk, San Antonio, TX 78245-9596 | 2020-09-01 |
| 1366055675 | Maria Christina Cruz Tijerina | Nurse Practitioner | 18518 Hardy Oak Blvd Apt 135, San Antonio, TX 78258-4759 | 2020-08-26 |
| 1225649593 | Gina M Duron | Nurse Practitioner | 10730 Green Trail Dr, San Antonio, TX 78223-4224 | 2020-08-11 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78229 |
Please comment or provide details below to improve the information on CCN MEDICAL SERVICES LLC.
| 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.