NICHOLAS HODGEMAN (NPI# 1679060578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679060578 |
| Entity Type | Individual |
| Full Name | NICHOLAS HODGEMAN |
| Credential | DO |
| Practice Address |
3551 Roger Brooke Dr. , Mche-zdm-m, Internal Medicine Residency Jbsa-fort Sam Houston TX 78234-4504 |
| Mailing Address |
3551 Roger Brooke Dr. Mche-zdm-m, Internal Medicine Residency Jbsa-fort Sam Houston TX 78234-4504 |
| Practice Telephone | 2109165910 |
| Practice Fax Number | 2109162077 |
| Mailing Telephone | 2109165910 |
| Mailing Fax Number | 2109162077 |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2020-04-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 0102205994 | VA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
3551 ROGER BROOKE DR. , MCHE-ZDM-M, INTERNAL MEDICINE RESIDENCY |
| City | JBSA-FORT SAM HOUSTON |
| State | TX |
| Zip Code | 78234-4504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235766569 | Shawn Kim | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr., Sammc, Mche-zdm-m, Internal Medicine Residency, Jbsa-fort Sam Houston, TX 78234 | 2020-03-25 |
| 1235764176 | Erik Hegeman | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr., Mche-zso, Orthopaedic Residency, Jbsa-fort Sam Houston, TX 78234-4504 | 2020-03-11 |
| 1780218743 | Josiah L Kietzman | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr., Mche-zdm-m, Internal Medicine Residency, Jbsa-fort Sam Houston, TX 78234-4504 | 2020-02-28 |
| 1740748466 | Ian Prichard | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr., Mche-zdm-m, Internal Medicine Residency, Jbsa-fort Sam Houston, TX 78234-4504 | 2019-03-12 |
| 1851885123 | Thomas Brian Lynch | Military Health Care Provider | 3551 Roger Brooke Dr., San Antonio Military Center, Mche-zso, Orthopaedic Resi, Jbsa-fort Sam Houston, TX 78234 | 2018-06-19 |
| 1972044568 | William Neale Bennett V | Internal Medicine | 3551 Roger Brooke Dr., Infectious Disease, Jbsa-fort Sam Houston, TX 78234-4504 | 2017-03-15 |
| 1578948964 | Cynthia Natalia Avery | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Dr., Sammc, Mche-mdx, Internal Medicine Residency., Jbsa-fort Sam Houston, TX 78238-4504 | 2015-07-27 |
| 1255764791 | Daniel Vernon Foster | General Practice | 3551 Roger Brooke Dr., San Antonio Military Medical Center, Mche-zdm-m, Jbsa-fort Sam Houston, TX 78234-4504 | 2013-08-20 |
| 1710229166 | John Leo Kiley | Internal Medicine | 3551 Roger Brooke Dr., Jbsa-fort Sam Houston, TX 78234-4504 | 2013-03-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255942884 | Thomas Ballas | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Drive Jbsa-fort Sam Houston, Department of Behavioral Medicine-mche-dbm, San Antonio, TX 78234 | 2020-08-17 |
| 1124657366 | Wendy Harris | Pharmacist | 3041 Garden Ave, Fort Sam Houston, TX 78234 | 2020-04-08 |
| 1215564729 | Travis Frantz | Student in an Organized Health Care Education/Training Program | 3551 Rodger Brooke Drive, Jbsa Fort Sam Houston, TX 78234 | 2020-03-25 |
| 1508492695 | Matthew Grossmann | Student in an Organized Health Care Education/Training Program | San Antonio Military Medical Center, Mche-zdm-m, Internal Medicine Residency, 3551 Roger Brooke Dr., Jbsa-fort Sam Houston, TX 78234 | 2020-03-20 |
| 1235793407 | Jessica Maria May Franklin | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Drive Jbsa Fort Sam Houston, San Antonio, TX 78234 | 2019-04-23 |
| 1730663477 | Glen Snyder | Military Health Care Provider | 3488 Garden Ave Anderson Hall, Fort Sam Houston, San Antonio, TX 78234 | 2018-09-19 |
| 1265919336 | Ashley Elizabeth Malawey | Military Health Care Provider | 3222 Cpl Johnson Road, San Antonio, TX 78234 | 2018-07-23 |
| 1053805515 | Rene Espinosa | Social Worker | San Antonio Medical Center, 3551 Roger Brooke Dr, Jbsa, TX 78234 | 2018-06-19 |
| 1235622333 | Melanie Edith Rivera | Military Health Care Provider | 3600 Roger Brooke Drive, San Antonio, TX 78234 | 2018-06-13 |
| 1063909158 | Benjamin Walker Appelo | General Practice | San Antonio Mil Med Center 3551 Roger Brooke Dr, Mche-zdm-m, San Antonio, TX 78234 | 2018-04-16 |
| Find all providers in zip 78234 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528565272 | Leilani Holbrook | General Practice | San Antonio Military Medical Center, Mche-zpl-a, Pathology Residency, 3551 Roger Brooke Dr, Jbsa-fort Sam Houston, TX 78234-4504 | 2018-04-10 |
| 1417453556 | Hannah Ruth Rose | General Practice | Sammc, Mche-zpla, Pathology Residency, 3551 Roger Brooke Dr, Jbsa-fort Sam Houston, TX 78234 | 2018-04-05 |
| 1346746914 | Rocky Fox | General Practice | San Antonio Military Medical Center, Mche-zdm-m, Internal Medicine Residency, 3551 Roger Brooke Dr., Jbsa-fort Sam Houston, TX 78234-4504 | 2018-04-03 |
| 1184129116 | Erin Swan | General Practice | San Antonio Military Center, Mche-zso, Orthopaedic Res, 3551 Roger Brooke Dr., Jbsa-fort Sam Houston, TX 78234-4504 | 2018-03-30 |
| 1285138214 | Lisa Claire Townsend | General Practice | Sammc, Mche-zdm-m, Internal Medicine Residency, 3551 Roger Brooke Dr, Jbsa-fort Sam Houston, TX 78234-4504 | 2018-03-23 |
| 1861996670 | Cynthia Renee Sacco | General Practice | San Antonio Military Medical Center, Mche-zsg Residency, 3551 Roger Brooke Drive, Jbsa-fort Sam Houston, TX 78234-4504 | 2018-03-19 |
| 1841792405 | Robert Thomas Powers | General Practice | Sammc, Mche-zso, Orthopaedic Residency, 3551 Roger Brooke Dr, Jbsa-fort Sam Houston, TX 78234 | 2018-02-28 |
| 1912431172 | Cyrus Veryl Edelson | General Practice | 3551 Roger Brooke Dr. Internal Medicine Residency, San Antonio Military Medical Center, Mche-zdm-m, Jbsa-fort Sam Houston, TX 78234-4504 | 2017-04-14 |
| 1275073561 | Jamie Geringer | General Practice | 3551 Roger Brooke Dr., Internal Medicine Residency, San Antonio Military Medical Center, Mche-zdm-m, Jbsa-fort Sam Houston, TX 78234-4504 | 2017-03-06 |
| 1790225662 | Kevin Peterson | General Practice | 3551 Rodger Brooke Dr, Anesthesia Residency, Jbsa-fort Sam Houston, TX 78234-4504 | 2017-02-27 |
| Find all providers in JBSA-FORT SAM HOUSTON | ||||
| City | JBSA-FORT SAM HOUSTON |
| Zip Code | 78234 |
Please comment or provide details below to improve the information on NICHOLAS HODGEMAN.
| 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.