JODIE K TIMBERLAKE (NPI# 1619219789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619219789 |
| Entity Type | Individual |
| Full Name | JODIE K TIMBERLAKE |
| Practice Address |
2200 Bergquist Dr Willford Hall Ambulatory Surgical Center Lackland A F B TX 78236-9907 |
| Practice Telephone | 2102925077 |
| Practice Fax Number | 2102927868 |
| Mailing Telephone | 2102925077 |
| Mailing Fax Number | 2102927868 |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2013-03-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
2200 BERGQUIST DR WILLFORD HALL AMBULATORY SURGICAL CENTER |
| City | LACKLAND A F B |
| State | TX |
| Zip Code | 78236-9907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235139494 | Kathryn Joyce | Nurse Practitioner | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2005-07-28 |
| 1467798884 | James W Parry | Military Health Care Provider | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2012-12-13 |
| 1093065252 | Brittany Mccright | Physical Therapist | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2012-09-14 |
| 1003177593 | Danielle Kusserow Bersabe | Internal Medicine | 2200 Bergquist Dr, Wilford Hall Ambulatory Surgical Center, Lackland A F B, TX 78236-9907 | 2012-05-31 |
| 1114206570 | Ana Ugues Aleman | Pharmacist | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2011-08-16 |
| 1902192743 | Ashley Noelle Franz | Student in an Organized Health Care Education/Training Program | 2200 Bergquist Dr, Wilford Hall Medical Center, Lackland A F B, TX 78236-9907 | 2011-06-20 |
| 1699067694 | Kristen Kann | Emergency Medicine | 2200 Bergquist Dr, Suite 1, Lackland A F B, TX 78236-9907 | 2011-05-09 |
| 1891090577 | Evan Gregory Smith | Physician Assistant | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2011-01-11 |
| 1295041853 | Santos Michael Rivera II | Pharmacist | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2010-08-20 |
| 1245545151 | Corey Dequan Cooper | Pharmacist | 2200 Bergquist Dr, Suite 1, Lackland A F B, TX 78236-9907 | 2010-08-16 |
| 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 | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902192743 | Ashley Noelle Franz | Student in an Organized Health Care Education/Training Program | 2200 Bergquist Dr, Wilford Hall Medical Center, Lackland A F B, TX 78236-9907 | 2011-06-20 |
| 1770881633 | Jennifer B Gillespie | Student in an Organized Health Care Education/Training Program | 2200 Bergquist Dr Ste 1, Lackland A F B, TX 78236-9908 | 2011-03-02 |
| 1437387735 | Reed Tyler Reichwald | Student in an Organized Health Care Education/Training Program | 2200 Bergquist Dr Ste 1, Lackland A F B, TX 78236-9908 | 2009-06-24 |
| 1700047156 | Lindsey Davies Kuschnerait | Student in an Organized Health Care Education/Training Program | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2008-06-18 |
| 1043492820 | Jared Brian Cooper | Student in an Organized Health Care Education/Training Program | 2200 Bergquist Dr Ste 1, Lackland A F B, TX 78236-9908 | 2007-12-03 |
| 1790982924 | Noah Marcus Miller | Student in an Organized Health Care Education/Training Program | 2450 Pepperrell St, Lackland A F B, TX 78236-5345 | 2007-06-29 |
| 1407052590 | Anna Zelfond Feldman | Student in an Organized Health Care Education/Training Program | 2200 Bergquist Dr Ste 1, Lackland A F B, TX 78236-9908 | 2007-06-25 |
| 1952516940 | Geoffrey J Oravec | Student in an Organized Health Care Education/Training Program | 2200 Bergquist Dr, Suite 1, Lackland A F B, TX 78236-9907 | 2007-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720688930 | Kourtney Tapnio | Student in an Organized Health Care Education/Training Program | 8215 Summer Breeze Ln, Rosenberg, TX 77469-1846 | 2020-10-27 |
| 1932708666 | Candice Carriere | Student in an Organized Health Care Education/Training Program | 211 Terrace Creek Ct, Richmond, TX 77406-3590 | 2020-10-23 |
| 1922607373 | Benjamin Allen Barrett | Student in an Organized Health Care Education/Training Program | 12244 Langley Hill Dr, Fort Worth, TX 76244-5544 | 2020-10-17 |
| 1538766597 | Billy Derek Huddleston | Student in an Organized Health Care Education/Training Program | 4661 Cool Ridge Ct, Fort Worth, TX 76133-3831 | 2020-10-02 |
| 1669089157 | Jacob Dainel Frost | Student in an Organized Health Care Education/Training Program | 1207 N Saint James Rd, Pilot Point, TX 76258-2715 | 2020-09-28 |
| 1821605569 | Madison Bettis | Student in an Organized Health Care Education/Training Program | 16609 Green Maze Ln, Helotes, TX 78023-3441 | 2020-09-27 |
| 1659987899 | Chinwe Nwakaego Dike | Student in an Organized Health Care Education/Training Program | 8023 Bueller Pass Ln, Richmond, TX 77407-1824 | 2020-09-22 |
| 1760098271 | Danielle Mortimer | Student in an Organized Health Care Education/Training Program | 1340 Prudential Dr Ste A, Dallas, TX 75235-4115 | 2020-09-20 |
| 1467067462 | Sami Al-aya | Student in an Organized Health Care Education/Training Program | 7114 Lyons Rd, Garland, TX 75043-6633 | 2020-09-15 |
| 1912512005 | Courtney Yates | Student in an Organized Health Care Education/Training Program | 2920 Northlake Cv, Tyler, TX 75703-7033 | 2020-09-15 |
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| City | LACKLAND A F B |
| 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.