MATTHEW LAURANCE REAGAN (NPI# 1821502683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1821502683 |
Entity Type | Individual |
Full Name | MATTHEW LAURANCE REAGAN |
Practice Address |
480 Central Ave Jbphh HI 96860-4908 |
Mailing Address |
10139 Glennon St San Diego CA 92124-2914 |
Practice Telephone | 8084731880 |
Mailing Telephone | 6192740158 |
Enumeration Date | 2017-11-30 |
Last Update Date | 2017-11-30 |
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 |
Other Service Providers |
Street Address |
480 CENTRAL AVE |
City | JBPHH |
State | HI |
Zip Code | 96860-4908 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255325072 | John K Nakagawa | Dentist | 480 Central Ave, Jbphh, HI 96860-4908 | 2005-09-07 |
1639792633 | Andrea Kahealani Stanley | Registered Nurse | 480 Central Ave, Jbphh, HI 96860-4908 | 2020-05-26 |
1427689926 | Anuree Bennett | Registered Nurse | 480 Central Ave, Jbphh, HI 96860-4908 | 2020-02-03 |
1366073512 | George Henry Alba | Registered Nurse | 480 Central Ave, Jbphh, HI 96860-4908 | 2020-01-27 |
1588203400 | Christina Marie Narayana | Registered Nurse | 480 Central Ave, Jbphh, HI 96860-4908 | 2019-12-23 |
1528602984 | Carrie P Yamamoto | Registered Nurse | 480 Central Ave, Jbphh, HI 96860-4908 | 2019-10-29 |
1356878995 | Daryl R Cadelina | Registered Nurse | 480 Central Ave, Jbphh, HI 96860-4908 | 2017-05-14 |
1396282232 | Jennifer Sua | Registered Nurse | 480 Central Ave, Jbphh, HI 96860-4908 | 2017-01-31 |
1912368705 | Heidi Layton | Psychologist | 480 Central Ave, Jbphh, HI 96860-4908 | 2016-03-08 |
1992162432 | Amy Lynn Bene | Registered Nurse | 480 Central Ave, Jbphh, HI 96860-4908 | 2016-01-27 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770075970 | April Box | Registered Nurse | Naval Health Clinic Hawii, 480 Central Avenue, Pearl Harbor, HI 96860 | 2018-06-04 |
1760985535 | Daniel Thomas Weinberg | General Practice | 1430 Morton St Bldg 619, Jbphh, HI 96860 | 2018-03-17 |
1003325366 | Justin Hesse | Military Health Care Provider | Building 17 Bishop Point, Pearl Harbor, HI 96860 | 2017-09-29 |
1982057816 | John Alois Kustermann | Family Medicine | 490 Central Avenue Bldg 281, Honolulu Military Entrance Processing Station, Pearl Harbor, HI 96860 | 2016-07-15 |
1104290519 | Carlton Jacob Maughan | Military Health Care Provider | Bldg 17 Bishops Point, Pearl Harbor, HI 96860 | 2015-11-23 |
1588079206 | Naval Health Clinic Hawaii | Military/U.S. Coast Guard Pharmacy | Makalapa Rd, Bldg 1407, Pearl Harbor, HI 96860 | 2014-06-23 |
1922349968 | Jose Israel Lopez | Military Health Care Provider | Mdsu-1 Bishop Point, Building 17, Pearl Harbor, HI 96860 | 2013-03-14 |
1790056620 | Lesley Brooke Dorsey | Physician Assistant | 408 Central Ave, Jbphh, HI 96860 | 2012-01-24 |
1184914061 | William A Talbott | Military Health Care Provider | 850 Ticonderoga St, Pearl Harbor, HI 96860 | 2011-04-13 |
1275860603 | Michael J. Rodriguez | Military Health Care Provider | 822 Clark St., Nssc Medical Suite 400, Pearl Harbor, HI 96860 | 2009-11-05 |
Find all providers in zip 96860 |
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 |
---|---|---|---|---|
1134759715 | David Maldonado Santiago | Military Health Care Provider | 590 Moffet St, Jbphh, HI 96853-5168 | 2020-01-22 |
1437574928 | Guy Edward Sargent | Military Health Care Provider | 480 Central Ave, Jbphh, HI 96860 | 2014-02-20 |
1740527589 | Cory John Butler | Military Health Care Provider | 310 Worchester Ave Bldg 45, Jbphh, HI 96853-5530 | 2013-01-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205441888 | William Andrew Fitzpatrick | Military Health Care Provider | Bldg 6905, Mcbh, HI 96734 | 2020-09-10 |
1215549670 | Joseph Frabotta | Military Health Care Provider | 6894r Mokapu Rd, Kailua, HI 96734 | 2020-08-18 |
1508484882 | David Jason Brown | Military Health Care Provider | 6255 Kaawa St, Kailua, HI 96734-4984 | 2020-07-13 |
1003325366 | Justin Hesse | Military Health Care Provider | Building 17 Bishop Point, Pearl Harbor, HI 96860 | 2017-09-29 |
1649796244 | Joshua I White | Military Health Care Provider | Bldg 4078 Harris Rd., Mcbh Kaneohe Bay, HI 96863 | 2017-08-16 |
1104290519 | Carlton Jacob Maughan | Military Health Care Provider | Bldg 17 Bishops Point, Pearl Harbor, HI 96860 | 2015-11-23 |
1811363120 | Timothy Layton | Military Health Care Provider | 1016 Ulupau Loop, Kailua, HI 96734-4772 | 2015-08-20 |
1700263001 | Daniel Joseph Engelhardt | Military Health Care Provider | 5435 Kilmer Ln, Honolulu, HI 96818-3467 | 2015-05-06 |
1316350168 | Bryan Goodman | Military Health Care Provider | Bldg #1058, Mcbh Kaneohe Bay, HI 96863 | 2014-06-10 |
1902249436 | Alex Joseph Valencia | Military Health Care Provider | 3005 Glen Cove, Kailua, HI 96734-3004 | 2013-04-15 |
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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.