DR. JORDAN ELLIS (NPI# 1972167161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972167161 |
| Entity Type | Individual |
| Full Name | DR. JORDAN ELLIS |
| Credential | PHD |
| Practice Address |
1100 Wilford Hall Loop Bldg. 4554, 59 Mdw/gme, Jbsa Lackland Jbsa Lackland TX 78236 |
| Practice Telephone | 2102925972 |
| Enumeration Date | 2019-04-24 |
| Last Update Date | 2020-08-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TH0004X |
Psychologist Specialization: Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891239901 | Jordan Ellis | Specialist/Technologist | 5814 S 105th St, Omaha, NE 68127-2909 | 2016-12-08 |
| 1144636275 | Jordan Marie Ellis | Nurse Practitioner | 1642 Westgate Cir Ste 202, Brentwood, TN 37027-8195 | 2014-07-09 |
| 1902398068 | Jordan Michael Ellis | Dentist | 1900 East Main St, Danville, IL 61832-6183 | 2018-06-05 |
| 1720534696 | Jordan E Ellis | Nurse Anesthetist, Certified Registered | 1836 South Ave, La Crosse, WI 54601-5429 | 2016-08-30 |
| Street Address |
1100 WILFORD HALL LOOP BLDG. 4554, 59 MDW/GME, JBSA LACKLAND |
| City | JBSA LACKLAND |
| State | TX |
| Zip Code | 78236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134113954 | Monica L. Wheaton | Advanced Practice Midwife | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2005-09-08 |
| 1811509763 | Megan Dial | Physical Therapist | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2020-08-21 |
| 1821614538 | Matthew Hetrick | Military Health Care Provider | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2020-06-18 |
| 1689297368 | Rachel E Hodge | Nurse Practitioner | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2020-05-28 |
| 1598385742 | Tora Jean Tornbom | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop, Bldg 4554, 59 Mdw/gme, Jbsa Lackland, TX 78236-5638 | 2020-04-17 |
| 1689236622 | Jessica Martinez Bennett | Nurse Practitioner | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2019-06-29 |
| 1073172565 | Robert A Kowtoniuk | General Practice | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2019-06-10 |
| 1124580311 | Christopher Berrios | Military Health Care Provider | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2019-04-05 |
| 1801352539 | Aeja Weiss | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2019-02-19 |
| 1083170252 | Kristen Garvie | General Practice | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2019-02-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
| 1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
| 1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
| 1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
| 1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
| 1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
| 1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
| 1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
| 1376906958 | David Kephart Jr. | General Practice | 1100 Wilford Hall Loop Bldg 4454, Jbsa Lackland, TX 78236 | 2016-04-01 |
| 1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
| Find all providers in zip 78236 | ||||
| Taxonomy Code | 103TH0004X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Health |
| The distinct focus of the clinical health psychologist is on physical health problems. A clinical health psychologist has special expertise or training in clinical health psychology and applies scientific knowledge of the interrelationships among behavioral, emotional, cognitive, social and biological components in health and disease to the promotion and maintenance of health; the prevention, treatment and rehabilitation of illness and disability; and the improvement of the health care system. Clinical health psychologists are dedicated to the development of knowledge regarding the interface between behavior and health, and to the delivery of high quality services based on that knowledge to individuals, families, and health care. |
| Notes: Source: American Psychological Association Commission for the Recognition of Specialties and Proficiencies in Professional Psychology, 2008. [1/1/2007: new, 7/1/2008: definiton added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679757173 | Gerald Wayne Talcott | Psychologist | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 | 2007-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326501461 | Rebecca Bridgefarmer | Psychologist | 415 Whitney Dr, Nevada, TX 75173-8344 | 2019-04-06 |
| 1952745028 | Ross Stewart | Psychologist | 14180 Dallas Pkwy Ste 520, Dallas, TX 75254-1334 | 2013-04-19 |
| 1720274186 | Debra J Archuleta | Psychologist | 8800 Village Dr Ste 209, San Antonio, TX 78217-5420 | 2007-09-19 |
| 1508405663 | Maria Mollica | Psychologist | 8200 Walnut Hill Ln, Dallas, TX 75231-4426 | 2020-01-06 |
| 1164905212 | Lauren Elizabeth Cox | Psychologist | 2222 Welborn St, Dallas, TX 75219-3924 | 2018-09-13 |
| 1659893816 | Desire Shenay Taylor | Psychologist | 4708 Alliance Blvd Ste 700, Plano, TX 75093-5317 | 2017-07-10 |
| 1467800300 | Psymed Health | Psychologist | 2014 Ben Merritt Dr, Suite A, Decatur, TX 76234-3850 | 2016-06-01 |
| 1710334107 | Serina Huerta | Psychologist | 4500 S Lancaster Rd, Dallas, TX 75216-7167 | 2016-05-16 |
| 1003275298 | Michael Chatterton | Psychologist | 3851 Roger Brooke Drive, Mche-qd (creds), Fort Sam Houston, TX 78234 | 2016-02-16 |
| 1750708863 | John Anthony Blue Star | Psychologist | 1100 Wilford Hall Loop, Lackland Afb, TX 78236-5638 | 2014-03-26 |
| Find all providers with the same taxonomy | ||||
| City | JBSA LACKLAND |
| Zip Code | 78236 |
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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.