MR. JASON ANTHONY EVANS (NPI# 1033452206) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033452206 |
| Entity Type | Individual |
| Full Name | MR. JASON ANTHONY EVANS |
| Credential | IDMT |
| Practice Address |
301 Fisher St Keesler Afb MS 39534-2508 |
| Mailing Address |
278 Fairchild Dr Biloxi MS 39531-3239 |
| Practice Telephone | 3106862656 |
| Mailing Telephone | 3106862656 |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2013-04-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1003X |
Military Health Care Provider Specialization: Independent Duty Medical Technicians |
Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144785130 | Jason Michael Evans | Chiropractor | 997 Raintree Cir Ste 170, Allen, TX 75013-4955 | 2019-02-05 |
| 1386189736 | Jason Evans | Nurse Anesthetist, Certified Registered | 506 6th Street, Brooklyn, Ny 11215, Brooklyn, NY 11215 | 2016-12-21 |
| 1861852022 | Jason Evans | Licensed Practical Nurse | 511 N 12th St, Miamisburg, OH 45342-1959 | 2016-03-02 |
| 1902825243 | Jason Charles Evans | Physician Assistant | 1095 W Huron St, Waterford, MI 48328-3735 | 2006-07-18 |
| 1093704306 | Jason Anthony Evans | Podiatrist | 2800 E Commercial Blvd, Suite 207, Fort Lauderdale, FL 33308-4229 | 2005-10-19 |
| 1982691911 | Jason Thomas Evans | Chiropractor | 732 S Washington Ave, Madison, SD 57042-3519 | 2005-10-04 |
| 1942799648 | Jason Colt Evans | Behavior Technician | 3650 Mt Diablo Blvd Ste 107, Lafayette, CA 94549-3780 | 2018-05-08 |
| 1407395262 | Jason Lamar Evans | Nurse Practitioner | 3700 Cahaba Beach Rd, Birmingham, AL 35242-5225 | 2017-02-13 |
| 1942675491 | Jason Evans | Physician Assistant | 311 Jones Mill Rd, Statesboro, GA 30458-4765 | 2015-12-09 |
| 1861823635 | Jason Charl Evans | Physician Assistant | 680 E Main St, Suite 201, Lehi, UT 84043-2241 | 2013-12-04 |
| Street Address |
301 FISHER ST |
| City | KEESLER AFB |
| State | MS |
| Zip Code | 39534-2508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215929039 | Roger E Pradelli | Dentist | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2005-08-17 |
| 1508427394 | Anthony Wayne Reddin Jr. | Nurse Anesthetist, Certified Registered | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2019-06-24 |
| 1215496575 | Benjamin Douglas | Physician Assistant | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2019-03-17 |
| 1801381736 | Francis Essien | Student in an Organized Health Care Education/Training Program | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2018-06-23 |
| 1932697893 | Eric James Rigg | Student in an Organized Health Care Education/Training Program | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2018-04-26 |
| 1912401084 | Shannon Reed | Advanced Practice Midwife | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2018-03-22 |
| 1568972586 | Nicholas P Robertson | Registered Nurse | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2017-10-04 |
| 1578093126 | Jaclyn Kaye Stacy | Internal Medicine | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2017-06-15 |
| 1700315686 | Joseph Cook | Internal Medicine | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2017-06-05 |
| 1861926461 | Benjamin Robert Prince | Family Medicine | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2017-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316568918 | Hanna Chang | Student in an Organized Health Care Education/Training Program | 81 Msgs/gme (keesler Afb), 301 Fisher St, Rm 5a127, Biloxi, MS 39534 | 2020-05-05 |
| 1720617079 | Briana Polk | Student in an Organized Health Care Education/Training Program | Keesler Air Force Base, 301 Fisher Street, Biloxi, MS 39534 | 2020-04-07 |
| 1437718756 | Marquise Westbrook | Student in an Organized Health Care Education/Training Program | 301 Fisher St, Rm 1g123, Keesler Afb, MS 39534 | 2019-06-11 |
| 1124682729 | Joseph Paul Cervone | Student in an Organized Health Care Education/Training Program | 81 Mdss/gme 301 Fisher St, Rm 1g123, Keesler Afb, MS 39534 | 2019-04-29 |
| 1083120851 | Kaitlin May Gruenberg | Student in an Organized Health Care Education/Training Program | 81 Msgs/gme, 301 Fisher St, Rm 5a127, Keesler Afb, MS 39534 | 2017-12-15 |
| 1760912513 | Michael Zipper | Military Health Care Provider | 301 Fisher St, Rm 5a127, 81msgs/sgcq, Keesler Afb, MS 39534 | 2017-06-14 |
| 1184073181 | 81msgs/sgcq | General Acute Care Hospital | 81msgs/sgcq, 301 Fisher St, Rm 5a127, Keesler Afb, MS 39534 | 2016-06-09 |
| 1174972772 | Usaf 81st Medical Group | Military Hospital | 81msgs/sgcq 301 Fisher St, Rm 5a127, Keesler Afb, MS 39534 | 2016-06-06 |
| 1548644677 | Jim Li | Dentist | 81st Medical Group, Keesler Afb, Apo, AA 39534 | 2015-07-18 |
| 1245610872 | Zachary Austin Masters | Surgery | 301 Fisher Street, Rm 5a127, Keesler Air Force Base, MS 39534 | 2015-06-09 |
| Find all providers in zip 39534 | ||||
| Taxonomy Code | 1710I1003X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Medical Technicians |
| An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians. |
| Notes: Source: Air Force Surgeon General Office [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073943288 | Anna Martin | Military Health Care Provider | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2013-11-25 |
| 1073846051 | Brandon C Kahili | Military Health Care Provider | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2009-09-09 |
| 1528391505 | James Lewis Strawn Iv | Military Health Care Provider | 301 Fisher St, Emergency Services, Keesler Afb, MS 39534-2508 | 2009-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679828842 | Lakedrian Guy | Military Health Care Provider | 980 Courthouse Rd Apt 1521, Gulfport, MS 39507-4298 | 2012-07-13 |
| 1699055616 | Ashley Elizabeth Gross | Military Health Care Provider | 605 Leigh Dr Apt F50, Columbus, MS 39705-3369 | 2011-08-22 |
| 1639472236 | Derrick Dewayne Sweat | Military Health Care Provider | 213 Mcnarney Dr, Biloxi, MS 39531-3191 | 2010-12-21 |
| 1306043641 | William Anthony Minor | Military Health Care Provider | 2603 Lower Gainsville Rd, Nattc Sbt 22, Ssc, MS 39529 | 2007-06-29 |
| 1811098361 | Alvin Watson | Military Health Care Provider | 630 Columbia St, Hattiesburg, MS 39401-2801 | 2006-09-26 |
| 1861099913 | Enrique I Padron | Military Health Care Provider | 301 Fisher St, Biloxi, MS 39534-2508 | 2020-10-01 |
| 1881229623 | Jesse Recarte | Military Health Care Provider | 301 Fisher St, Biloxi, MS 39534-2508 | 2020-03-11 |
| 1356994362 | Zsane Wrice | Military Health Care Provider | 301 Fisher St, Biloxi, MS 39534-2508 | 2019-07-18 |
| 1336608702 | Alexa Duesler | Military Health Care Provider | 500 Fisher St, Biloxi, MS 39534-2502 | 2019-03-15 |
| 1992190425 | Seth Haas | Military Health Care Provider | 301 Fisher St, Biloxi, MS 39534-2508 | 2015-04-01 |
| Find all providers with the same taxonomy | ||||
| City | KEESLER AFB |
| Zip Code | 39534 |
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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.