ELLIOTT BENNETT PIPPEN (NPI# 1710231600) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710231600 |
| Entity Type | Individual |
| Full Name | ELLIOTT BENNETT PIPPEN |
| Credential | IDC |
| Practice Address |
1804 Gravenhurst Dr Virginia Beach VA 23464-8656 |
| Practice Telephone | 7573739095 |
| Mailing Telephone | 7573739095 |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2012-10-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| Street Address |
1804 GRAVENHURST DR |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23464-8656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437610581 | Ainsley's Angels of America | Durable Medical Equipment & Medical Supplies | 828 Cabrini Place, Virginia Beach, VA 23464 | 2019-03-29 |
| 1104313055 | Your Family Is Family Home Healthcare Services, LLC | Respite Care | 1311 Hafford Road, Virginia Beach, VA 23464 | 2018-04-17 |
| 1497274765 | Jamie Crisman | Occupational Therapist | 1400 Fordham Drive, Virginia Beach, VA 23464 | 2017-09-18 |
| 1861919334 | Joshua Hoxter | Chiropractor | 6070 Indian River Rd Ste 102, Virginia Beach, VA 23464 | 2017-08-25 |
| 1669909917 | Toni Faye Tayag | Specialist/Technologist | 909 Tidemark Court, Virginia Beach, VA 23464 | 2017-05-17 |
| 1922545540 | Divinefavor LLC | Non-emergency Medical Transport (VAN) | 1014 Level Green Blvd, Virginia Beach, VA 23464 | 2017-01-20 |
| 1326499807 | David Klucznik | Dentist | 5564 Indian River Road, Virginia Beach, VA 23464 | 2016-06-27 |
| 1093161374 | Mawussi Komi | General Acute Care Hospital | 6271 Drew Dr, Va Beach, VA 23464 | 2016-05-05 |
| 1588071807 | Linda Mathis | Skilled Nursing Facility | 5520 Indian Road, Virginia Beach, VA 23464 | 2014-07-18 |
| 1083045561 | Manny-nelson Med LLC | Durable Medical Equipment & Medical Supplies | 1612 Centerville Turnpike, Suite 308, Virginia Beach, VA 23464 | 2013-12-09 |
| Find all providers in zip 23464 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306455522 | Kevin Bradley | Military Health Care Provider | 903 13th St, Virginia Beach, VA 23451-4476 | 2020-07-23 |
| 1851900088 | Seth Walter | Military Health Care Provider | 1825 Olympic Dr, Virginia Beach, VA 23453-3720 | 2020-07-23 |
| 1912545534 | Ashton Neal Burnett | Military Health Care Provider | 1875 Cove Rd Bldg 3806, Virginia Beach, VA 23459-8911 | 2019-12-13 |
| 1578056743 | Elis Bojaxhi | Military Health Care Provider | 3044 Ashlawn Ter, Virginia Beach, VA 23452-6508 | 2018-06-12 |
| 1497298616 | Mario Zavala | Military Health Care Provider | 408 N Amsterdam Ct, Virginia Beach, VA 23454-4213 | 2016-11-19 |
| 1568904738 | Pierce Cogburn | Military Health Care Provider | 3985 Old Forge Rd, Virginia Beach, VA 23452-2173 | 2016-11-04 |
| 1851841449 | John Douglas Moore | Military Health Care Provider | 1004 Hermitage Rd Bldg 1014, Virginia Beach, VA 23459-9100 | 2016-10-07 |
| 1730559618 | Aaron Joseph Cortina | Military Health Care Provider | 2340 Amphibious Dr, Bldg 2012 Suite 125, Virginia Beach, VA 23459-8810 | 2015-10-05 |
| 1427430297 | Daniel Anthony Leonesio | Military Health Care Provider | 1432 Pandoria Ct, Virginia Beach, VA 23455-3738 | 2015-06-29 |
| 1346659570 | Nicholas Charles Edward Rohde | Military Health Care Provider | 4946 Juno Rd, Virginia Beach, VA 23455-2244 | 2014-08-13 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23464 |
Please comment or provide details below to improve the information on ELLIOTT BENNETT PIPPEN.
| 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.