MRS. JAMIE L BACK (NPI# 1881837755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881837755 |
| Entity Type | Individual |
| Full Name | MRS. JAMIE L BACK |
| Other Name | MRS. JAMIE L SHELTON |
| Credential | REGISTERED |
| Practice Address |
650 Joel Dr Fort Campbell KY 42223-5318 |
| Mailing Address |
3701 Reddick Rd Palmyra TN 37142-2127 |
| Practice Telephone | 2709560088 |
| Mailing Telephone | 9316249695 |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2009-04-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZE0500X |
Specialist/Technologist, Other Specialization: EEG |
8325 | TN | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
650 JOEL DR |
| City | FORT CAMPBELL |
| State | KY |
| Zip Code | 42223-5318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982601803 | Carol Lynn Pasewark | Counselor | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2005-07-07 |
| 1568063519 | Jeremy Schadewald | Physician Assistant | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-11-05 |
| 1578164760 | Brandi Mangan | Nurse Practitioner | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-11-04 |
| 1912506692 | Rose Dunn | Optometrist | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-10-22 |
| 1659989440 | Patrick Ogden | Student in an Organized Health Care Education/Training Program | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-07-17 |
| 1487262408 | John William Zamora | Physician Assistant | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-07-15 |
| 1295343218 | Joshua Ryan Agard | Physician Assistant | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-07-15 |
| 1902424435 | Shaina Escribano-miranda | Nurse Practitioner | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-07-10 |
| 1326665514 | Cristal Lagail Trotter | Nurse Anesthetist, Certified Registered | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-07-03 |
| 1689209728 | William James Bradshaw | Physician Assistant | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-03-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558978825 | Eden Addisu Kebede | Social Worker | Ft. Campbell/bach, 650 Joel Drive, Fort Campbell, KY 42223 | 2020-09-30 |
| 1174134662 | Lucas Pepper | Dentist | Desert Storm Ave, Bldg 5580, Apo, AA 42223 | 2020-08-10 |
| 1639711203 | Travis Robert Bryant | Optometrist | 5979 Desert Storm Ave., Lapointe Health Clnic Optometry, Ft. Campbell, KY 42223 | 2019-10-15 |
| 1184138232 | Vanessa Renee Simmons | Dental Assistant | 302b Baker St, Fort Campbell, KY 42223 | 2017-11-28 |
| 1922451996 | Isabella Julson | Dental Assistant | Bldg2441 21st Street, Us Army Dental Activity, Fort Campbell, KY 42223 | 2016-07-14 |
| 1336595305 | Heidi Cameron | Acupuncturist | 2889b Idaho Avenue, Fort Campbell, KY 42223 | 2016-05-10 |
| 1649644154 | Nathan Silvey | Physician Assistant | Building 4179, Fort Campbell, KY 42223 | 2015-11-20 |
| 1396145306 | Blanchfield Army Community Hospital | Clinic/Center | Bldg 2403, Air Assault St and Indiana Ave, Fort Campbell, KY 42223 | 2014-08-27 |
| 1275948564 | Rodney C Merkley | Psychologist | Building 3929, Ft. Capmbell, KY 42223 | 2014-06-25 |
| 1659785053 | Blanchfield Army Community Hospital | Clinic/Center | Bldg 6747 A Shau Valley Road, Fort Campbell, KY 42223 | 2014-06-13 |
| Find all providers in zip 42223 | ||||
| Taxonomy Code | 246ZE0500X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | EEG |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063890465 | Neurotech, LLC | Specialist/Technologist, Other | 4010 Dupont Cir Ste 230, Louisville, KY 40207-4847 | 2015-05-18 |
| 1083854152 | Dendrite Intra-operative Monitoring | Specialist/Technologist, Other | 8813 Swan Hill Rd, Louisville, KY 40241-1149 | 2009-03-02 |
| City | FORT CAMPBELL |
| Zip Code | 42223 |
Please comment or provide details below to improve the information on MRS. JAMIE L BACK.
| 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.