MR. RANDLE SCOTT GROVES (NPI# 1740710557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740710557 |
| Entity Type | Individual |
| Full Name | MR. RANDLE SCOTT GROVES |
| Credential | IDC |
| Practice Address |
Psns&imf Det Everett 2000 West Marine Drive, Bldg 2202 Everett WA 98207 |
| Mailing Address |
Psns&imf Det Everett 2000 West Marine Dr Bldg 2202 Everett WA 98207-0001 |
| Practice Telephone | (425) 304-5306 |
| Practice Fax Number | 4253045514 |
| Mailing Telephone | 4253045306 |
| Mailing Fax Number | 4253045514 |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2017-06-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
CA | Other Service Providers |
| Street Address |
PSNS&IMF DET EVERETT 2000 WEST MARINE DRIVE, BLDG 2202 |
| City | EVERETT |
| State | WA |
| Zip Code | 98207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225250616 | Peter Cowley | Dentist | 2000 West Marine View Drive, Building 2010, Everett, WA 98207 | 2007-05-03 |
| 1154491132 | Gary Matthew Virdell | Military Health Care Provider | Naval Health Clinic, Naval Station Everett, Bldg 2110, Everett, WA 98207 | 2006-11-08 |
| 1780787648 | Thomas W Greisamer | Psychiatry & Neurology | 2000 W. Marine View, Building 2010, Branch Health Clinic Evertt, Everett, WA 98207 | 2006-09-06 |
| 1134674500 | Rayna Herren | Psychologist | 2000 West Marine View Drive, Everett, WA 98207 | 2016-08-16 |
| 1316140858 | Branch Medical Clinic Everett | Clinic/Center | 2000 W Marine View Dr, Bldg 2010, Everett, WA 98207 | 2007-06-11 |
| 1033270848 | Jeremy S Ennis | Family Medicine | 2000 W Marine View Dr, Everett, WA 98207 | 2006-12-13 |
| 1952408718 | Naval Hospital Bremerton | Military/U.S. Coast Guard Pharmacy | 2000 W Marine View Dr, Everett, WA 98207 | 2006-09-20 |
| 1083090773 | Anthony Michael Belekanich | Optometrist | Naval Branch Health Clinic Everett, 2000 West Marine View Drive, Everett, WA 98207-0001 | 2015-08-04 |
| 1013233782 | Scott A Yount | Radiologic Technologist | Msron Nine 2000 W Marine View Dr, Everett, WA 98207-0001 | 2010-04-20 |
| 1659514859 | Maritime Expeditionary Security Squadron Nine | Military Hospital | 2000 W Marine View Dr Bldg 2134, Everett, WA 98207-0001 | 2009-04-17 |
| Find all providers in zip 98207 | ||||
| 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 |
|---|---|---|---|---|
| 1154491132 | Gary Matthew Virdell | Military Health Care Provider | Naval Health Clinic, Naval Station Everett, Bldg 2110, Everett, WA 98207 | 2006-11-08 |
| 1487723532 | Karl Frederic Matous | Military Health Care Provider | Msron 9 Naval Station Everett, 2000 Marine View Drive Building 2134, Everett, WA 98207-0001 | 2006-11-06 |
| 1487621942 | Tim Andrew Coffey | Military Health Care Provider | Medical Department Uss Abraham Lincoln, Fpo-ap, Everett, WA 96612-2872 | 2006-03-03 |
| 1689933210 | Nicolas Shane Gomez | Military Health Care Provider | 2000 W Marine View Dr, Bldg 2202 Psns/imf Dive Locker - Medical, Everett, WA 98207-0001 | 2012-05-16 |
| 1306044268 | Armando Garza | Military Health Care Provider | 2000 W Marine View Dr, Everett, WA 98207-0001 | 2007-07-03 |
| 1326171570 | Andre Maurice Cardenas | Military Health Care Provider | 2000 W Marine View Dr, Bldg 2010, Everett, WA 98207-0001 | 2007-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669022810 | Shannon Dawkins | Military Health Care Provider | 2150 Thresher Ave, Silverdale, WA 98315-2103 | 2019-09-18 |
| 1669033098 | Crystal Belle Phipps Bloomfeldt | Military Health Care Provider | 214 Autumn Hills Rd, Kelso, WA 98626-9018 | 2019-06-26 |
| 1649830779 | Monica Yineman | Military Health Care Provider | 9812 Enchantment Ave Nw, Silverdale, WA 98383-8822 | 2019-06-20 |
| 1164992491 | Michael Thomas Stevens | Military Health Care Provider | 100 Hospital Loop, Fairchild Afb, WA 99011 | 2018-11-29 |
| 1326521097 | Elizabeth Nicole Sifuentes | Military Health Care Provider | Uss Michigan- Commander Sub Group Nine, 2150 Thresher Ave, Silverdale, WA 98315-2150 | 2018-09-10 |
| 1235599234 | Corey Thacker | Military Health Care Provider | 1912 Nw Circle Dr N, Poulsbo, WA 98370-9527 | 2016-03-03 |
| 1679965222 | Asher Abbott White Jr. | Military Health Care Provider | 8806 86th Ave Nw, Gig Harbor, WA 98332-6752 | 2015-02-19 |
| 1023414927 | Larry Jones | Military Health Care Provider | 386 Nw Dory Dr, Oak Harbor, WA 98277-2077 | 2014-11-05 |
| 1598027237 | Epafara Jeffrey Vaitautolu | Military Health Care Provider | 30 Wencker Way Apt A, Bremerton, WA 98312-1861 | 2012-06-08 |
| 1841595352 | Brandon Alexander Martinfrazier | Military Health Care Provider | 610 Dowell St., Bldg. 6, Keyport, WA 98345 | 2011-01-13 |
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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.