JONATHAN DAVID BRUSHERD


Address: 710 Summit Loop, Rogers, AR 72756-3040
Phone: 4796447775

JONATHAN DAVID BRUSHERD (NPI# 1548826308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1548826308
Entity Type Individual
Full Name JONATHAN DAVID BRUSHERD
Credential SOIDC
Practice Address 710 Summit Loop
Rogers
AR 72756-3040
Mailing Address 304 Sea Hunter Way
Sneads Ferry
NC 28460-6012
Practice Telephone 4796447775
Mailing Telephone 4796447775
Enumeration Date 2019-05-16
Last Update Date 2019-05-16
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1710I1002X Military Health Care Provider
Specialization: Independent Duty Corpsman
Other Service Providers

Office Location

Street Address 710 SUMMIT LOOP
City ROGERS
State AR
Zip Code 72756-3040

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1295081529 Aaron Lee Matthews Sr. Counselor 411 W Poplar St., Rogers, AR 72756 2012-07-24
1538420286 Allison R Corter Speech-Language Pathologist 1000 W. Poplar St, Rogers, AR 72756 2012-05-30
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Taxonomy Information

Taxonomy Code 1710I1002X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Corpsman

Taxonomy Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new]

Competitor

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City ROGERS
Zip Code 72756

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Dataset Information

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.

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