DR. JAMIE LYNN JAQUA (NPI# 1639360811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639360811 |
| Entity Type | Individual |
| Full Name | DR. JAMIE LYNN JAQUA |
| Credential | MD |
| Practice Address |
520 Madison Oak Dr San Antonio TX 78258-3912 |
| Mailing Address |
4535 Dressler Rd Nw Canton OH 44718-2545 |
| Practice Telephone | 2102974050 |
| Mailing Telephone | 3309944731 |
| Mailing Fax Number | 3304098898 |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2020-06-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0204X |
Pediatrics Specialization: Pediatric Emergency Medicine |
P6362 | TX | Allopathic & Osteopathic Physicians |
| N | 2080P0204X |
Pediatrics Specialization: Pediatric Emergency Medicine |
2010-01200 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5920138 | 05 | |
| MYUTMB 4661837281 | 4661837281 | 01 |
| Street Address |
520 MADISON OAK DR |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78258-3912 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033182977 | Sandra R Aviles | Pediatrics | 520 Madison Oak Dr, San Antonio, TX 78258-3913 | 2006-02-10 |
| 1073134151 | Farahnaz Shafiey | Anesthesiologist Assistant | 520 Madison Oak Dr, San Antonio, TX 78258-3913 | 2020-04-30 |
| 1316401326 | Russell Aaron Bryan | Nurse Practitioner | 520 Madison Oak Dr, San Antonio, TX 78258-3912 | 2019-01-23 |
| 1861977464 | Jennifer Kay Nagel | Registered Nurse | 520 Madison Oak Dr, San Antonio, TX 78258-3912 | 2018-09-28 |
| 1538676838 | Omurkan Mira Finley | Nurse Practitioner | 520 Madison Oak Dr, San Antonio, TX 78258-3913 | 2018-01-08 |
| 1548631690 | Bve Group Pllc | Anesthesiology | 520 Madison Oak Dr, San Antonio, TX 78258-3913 | 2015-10-15 |
| 1104219781 | Pediatric Inpatient Critical Care Services Pa | Pediatrics | 520 Madison Oak Dr, San Antonio, TX 78258-3913 | 2015-03-06 |
| 1972816692 | River City Pediatric Emergency Physicians, Pllc | Emergency Medicine | 520 Madison Oak Dr, San Antonio, TX 78258-3913 | 2010-07-22 |
| 1629203195 | Esmeralda Lugo | Internal Medicine | 520 Madison Oak Dr, San Antonio, TX 78258-3913 | 2009-05-27 |
| 1831341189 | Suneetha Muthyala | Internal Medicine | 520 Madison Oak Dr, North Central Baptist Hospital, San Antonio, TX 78258-3913 | 2008-10-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356980163 | Jeffrey M. Martinez, M.d., P.a. | Surgery | 525 Centre Oak Drive, Suite 140, San Antonio, TX 78258 | 2019-12-26 |
| 1588226211 | New Life Brace and Limb, LLC | Prosthetist | 300 E. Sonterra Blvd., Suite 220, San Antonio, TX 78258 | 2019-07-02 |
| 1720649080 | Miguel Ibarra | Pharmacist | 18866 Stone Oak Pkwy., St.101, San Antonio, TX 78258 | 2019-06-26 |
| 1528538113 | Kevin Scott Farnsworth | Dentist | 1130 E. Sonterra Blvd Suite 100, San Antonio, TX 78258 | 2018-11-27 |
| 1891262176 | Dentists of Stone Oak, PC | Dentist | 23714 Hardy Oak Blvd, Suite 110, San Antonio, TX 78258 | 2018-10-25 |
| 1003399437 | Jesus Alcala | Physical Therapist | 20821 Us Hwy 281 N, Ste 110, San Antonio, TX 78258 | 2018-09-11 |
| 1184106544 | Marissa Kaye Bruton | Occupational Therapist | 505 Madison Oak, San Antonio, TX 78258 | 2018-09-02 |
| 1508346933 | Desiree Carroll | Occupational Therapy Assistant | 18803 Hardy Oak Drive, San Antonio, TX 78258 | 2018-08-15 |
| 1700376456 | Conner Jay Mcnabb | Optometrist | 810 Knights Cross Dr Ste 101, San Antonio, TX 78258 | 2018-05-17 |
| 1982191516 | Freehand Solutions LLC | Chiropractor | Nec Stone Oak Parkway & Loop 1604, San Antonio, TX 78258 | 2018-04-19 |
| Find all providers in zip 78258 | ||||
| Taxonomy Code | 2080P0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Emergency Medicine |
| A pediatrician who has special qualifications to manage emergencies in infants and children. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972997500 | Alexander Henri | Pediatrics | 315 N San Saba Ste 1135, San Antonio, TX 78207 | 2015-03-20 |
| 1831506757 | Sheetal Khiyani | Pediatrics | 333 N Santa Rosa St, San Antonio, TX 78207-3108 | 2014-07-14 |
| 1487829115 | Tracy Elizabeth Mccallin | Pediatrics | 333 N Santa Rosa St, San Antonio, TX 78207-3108 | 2008-04-23 |
| 1104001957 | Travis Emergency Physicians Pllc | Pediatrics | 333 N Santa Rosa Ave, San Antonio, TX 78207-3108 | 2007-12-28 |
| 1689854895 | Ashu Kumar | Pediatrics | 333 N Santa Rosa St, San Antonio, TX 78207-3108 | 2007-11-06 |
| 1073625430 | Farooq Mirza | Pediatrics | 333 N Santa Rosa Ave, Christus Santa Rosa Childrens Hospital, San Antonio, TX 78207-3108 | 2006-08-31 |
| 1316961402 | Allen R Potter | Pediatrics | 8401 Datapoint Dr, Suite 500, San Antonio, TX 78229-5907 | 2006-07-26 |
| 1093735375 | Sebrina D Perkins | Pediatrics | 4204 Gardendale St, Ste 312, San Antonio, TX 78229-3132 | 2006-07-20 |
| 1467480624 | David Bruce Newby | Pediatrics | 315 N San Saba, Suite 1135, San Antonio, TX 78207-3154 | 2006-06-28 |
| 1669408779 | Richard S Wayne | Pediatrics | 333 N Santa Rosa St, San Antonio, TX 78207-3108 | 2006-06-23 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78258 |
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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.