JOSHUA BRYCE KESSACK (NPI# 1629503180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629503180 |
| Entity Type | Individual |
| Full Name | JOSHUA BRYCE KESSACK |
| Credential | D.O. |
| Practice Address |
375 Amds 310 Losey St Scott Afb IL 62225 |
| Mailing Address |
310 W Losey St Scott Afb IL 62225-5250 |
| Practice Telephone | 6182565203 |
| Mailing Telephone | 4255189587 |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2020-03-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 5101024380 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
375 AMDS 310 LOSEY ST |
| City | SCOTT AFB |
| State | IL |
| Zip Code | 62225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011645 | Cheryl D Jones | Registered Nurse | 375th Mdg, 310 W. Losey Street, Scott Afb, IL 62225 | 2020-04-13 |
| 1649836123 | Benjamin Truong | Student in an Organized Health Care Education/Training Program | Scott Air Force Base, 307 West Losey Street Building #1535, Apo, AA 62225 | 2019-05-10 |
| 1558925669 | Brian Ng | Student in an Organized Health Care Education/Training Program | South Drive, Scott Afb, Illinois, Apo, AA 62225 | 2019-04-24 |
| 1841853710 | Lance Scott Mcgavin | Student in an Organized Health Care Education/Training Program | 307 West Losey Street., Building #1535, Scott Afb, IL 62225 | 2019-04-17 |
| 1265988059 | Jennifer Nicole Laurence | Dentist | 703 Seibert Rd Ste 5, Scott Afb, IL 62225 | 2016-08-31 |
| 1578940755 | Usv Optical Inc | Eyewear Supplier (Equipment, not the service) | 207 W. Winters St., Bldg 1981, Scott Afb, IL 62225 | 2015-04-27 |
| 1891193652 | Diana Meyer | Social Worker | Scott Afb, Apo, AA 62225 | 2014-12-10 |
| 1801210273 | Robie Victoria Hughes | Registered Nurse | 310 W Losey Street, Scott Air Force Base, IL 62225 | 2014-02-06 |
| 1487998746 | Melissa Dawn Goff | Military Health Care Provider | 310 West. Losey Street, Scott Afb, IL 62225 | 2012-11-26 |
| 1477784312 | Derek Cowen | Military Health Care Provider | 505 Rimkus Drive, Scott Air Force Base, IL 62225 | 2009-07-27 |
| Find all providers in zip 62225 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245213479 | Chad C Carter | General Practice | 2400 East Dr Rm 135, Scott Afb, IL 62225-5408 | 2005-11-22 |
| 1235521337 | Steven Fogger | General Practice | 310 W Losey St, Scott Afb, IL 62225-5250 | 2015-02-26 |
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| Find all providers with the same taxonomy | ||||
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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.