JMJ3 HERITAGE, L.L.C. (NPI# 1548681950) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548681950 |
| Entity Type | Organization |
| Organization Name | JMJ3 HERITAGE, L.L.C. |
| Practice Address |
3800 Commerce Blvd Davenport IA 52807-3495 |
| Mailing Address |
3135 52nd Avenue Ct Bettendorf IA 52722-6953 |
| Practice Telephone | 5633221888 |
| Mailing Telephone | 5635085139 |
| Mailing Fax Number | 5633593828 |
| Enumeration Date | 2014-01-02 |
| Last Update Date | 2014-01-02 |
| Authorized Official Name | NAOMI CHELLI (ORGANIZER) |
| Authorized Official Telephone | 5635085139 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 35355 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | ILLINOIS LICENSE | 036111692 | 01 |
| IA | IOWA LICENSE | 35355 | 01 |
| Street Address |
3800 COMMERCE BLVD |
| City | DAVENPORT |
| State | IA |
| Zip Code | 52807-3495 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932362431 | Manorcare Health Services LLC | Skilled Nursing Facility | 3800 Commerce Blvd, Davenport, IA 52807-3495 | 2008-07-03 |
| 1871921429 | Elena Evgenievna Bethel | Nurse Practitioner | 3800 Commerce Blvd, Davenport, IA 52807-3495 | 2013-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710455423 | Sarah Duvall | Pharmacist | 2790 East 53rd Street, Davenport, IA 52807 | 2018-11-12 |
| 1932686375 | Costco Wholesale Corporation | Hearing Aid Equipment | 2790 East 53rd St., Davenport, IA 52807 | 2018-07-27 |
| 1902258379 | Secure Dental II, LLC | Dentist | 5025 Utica Ridge Rd, Suite 103, Davenport, IA 52807 | 2016-07-08 |
| 1003288663 | Kristin Landram | Pharmacist | 4011 E 53rd Street, Davenport, IA 52807 | 2015-10-22 |
| 1912384918 | Toshia Johnson | Counselor | 3515 Spring Street, Davenport, IA 52807 | 2015-04-29 |
| 1366849440 | Dennis Aaron Brown | Counselor | 2322 E. Kimberly Rd., Ste. 200 N., Davenport, IA 52807 | 2014-12-04 |
| 1033514914 | Rachel J Staron | Counselor | 2028 E 38th St Ste 3-5, Davenport, IA 52807 | 2014-11-04 |
| 1447651518 | Anthony B. Dexter | Chiropractor | 2178 E Kimberly Rd Ste 400, Davenport, IA 52807 | 2014-09-09 |
| 1932517588 | Alan Christopher Rubach | Dentist | 3435 Spring St Ste 2, Davenport, IA 52807 | 2014-07-28 |
| 1851707459 | Allison Maxwell | Behavioral Analyst | 4959 Utica Ridge Rd, Davenport, IA 52807 | 2014-07-03 |
| Find all providers in zip 52807 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013474063 | Surgeons of Central Florida LLC | General Practice | 755 Jay Bee Avenue, Davenport, FL 33897 | 2019-02-26 |
| 1902138951 | Jack Eff | General Practice | 1556 Challenger Ave, Davenport, FL 33897-6404 | 2010-02-02 |
| 1912130527 | Ismael Ruiz-de La Rosa I | General Practice | 111 Webb Dr Ste 475, Davenport, FL 33837 | 2009-08-29 |
| 1932301900 | James Richard Lucas | General Practice | 202 Broadway Ave., Davenport, OK 74026 | 2007-06-01 |
| 1366503583 | Reyna Isabel Lajara | General Practice | 127 Ridge Center Dr, Davenport, FL 33837-6401 | 2006-12-12 |
| 1265430961 | Quad City Family Physicians, PC | General Practice | 3940 N Marquette St, Davenport, IA 52806-4430 | 2005-07-07 |
| 1144510124 | Keyshla Marie Rivera Baez | General Practice | 111 Webb Dr, Davenport, FL 33837 | 2011-04-12 |
| 1477709160 | Ladapo Shyngle | General Practice | 121 Webb Dr, Suite 100, Davenport, FL 33837-3904 | 2008-08-13 |
| 1093852113 | Teodoro Medina | General Practice | 111 Webb Dr, Davenport, FL 33837-3962 | 2007-01-30 |
| 1306802905 | Charlene Edmee D'acosta | General Practice | 111 Webb Dr, Davenport, FL 33837 | 2006-04-22 |
| Find all providers in DAVENPORT | ||||
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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.