DR. JAMES RANDALL ELLIOTT


Address: 95 Amds/sgp, 55 N. Wolfe Ave., Edwards Afb, CA 93524-0001
Phone: 6612771130

DR. JAMES RANDALL ELLIOTT (NPI# 1124081971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1124081971
Entity Type Individual
Full Name DR. JAMES RANDALL ELLIOTT
Credential MD, MPH
Practice Address 95 Amds/sgp
55 N. Wolfe Ave.
Edwards Afb
CA 93524-0001
Practice Telephone 6612771130
Practice Fax Number 6612770688
Mailing Telephone 6612771130
Mailing Fax Number 6612770688
Enumeration Date 2006-04-11
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor X

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
X 2083A0100X Preventive Medicine
Specialization: Aerospace Medicine
95-230 NM Allopathic & Osteopathic Physicians
X 2083P0901X Preventive Medicine
Specialization: Public Health & General Preventive Medicine
95-230 NM Allopathic & Osteopathic Physicians

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Office Location

Street Address 95 AMDS/SGP
55 N. WOLFE AVE.
City EDWARDS AFB
State CA
Zip Code 93524-0001

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1114540499 Nathaniel George Brown Student in an Organized Health Care Education/Training Program 412th Medical Group 30 Nightingale Rd., Building #5525, Edwards Air Force Base, CA 93524 2020-05-21
1265852396 Wesley John Fischer Pharmacist 30 Nightengale Road, Edwards U.S. Air Force Base Pharmacy, Edwards, CA 93524 2014-04-16
1659567493 Kevin Ray Hooker Social Worker 30 Nightingale Road, 5513, Lancaster, CA 93524 2007-09-14
1336655943 Keith Janda Physician Assistant 95th Medical Group 30 Nightingale Road Building 5525, Edwards Afb, CA 93524-0001 2017-12-19
1598286049 Mackenzie Johnson Clevenger Pharmacist 412 Mdg 30 Nightingale Rd, Edwards Afb, CA 93524-0001 2017-07-05
1245751460 Brandon John Potters Military Health Care Provider Air Test and Evaluation Squadron Nine Rd 187 Rd, Edwards Afb, CA 93524-0001 2017-06-28
1003266073 Meshva Akwalia Pediatrics 412 Medical Group 30 Nightingale Rd Bldg 5525, Edwards Afb, CA 93524-0001 2016-06-20
1144613670 Pang Ko Dentist 30 Nightingale Ave Building 5513, Edwards, CA 93524-0001 2015-03-09
1710293345 Tonya Nicole Barry Dentist Bldg 3925, 31 Nightingale Rd, Edwards Afb, CA 93524-0001 2010-08-20
1265761340 Shanda R. Marshall Nurse Practitioner 412 Th Medical Grouup, 30 Nightingale Road, Edwards, CA 93524-0001 2009-12-18
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Taxonomy Information

Taxonomy Code 2083A0100X
Grouping Allopathic & Osteopathic Physicians
Classification Preventive Medicine
Specialization Aerospace Medicine

Taxonomy Definition

Aerospace medicine focuses on the clinical care, research, and operational support of the health, safety, and performance of crewmembers and passengers of air and space vehicles, together with the support personnel who assist operation of such vehicles. This population often works and lives in remote, isolated, extreme, or enclosed environments under conditions of physical and psychological stress. Practitioners strive for an optimal human-machine match in occupational settings rich with environmental hazards and engineering countermeasures.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine.

Providers in the same taxonomy and state

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1144592098 Joel Andrew Fulkerson Preventive Medicine Bldg 22190, Camp Pendleton, CA 92058-2111 2012-02-07
1427373398 Gregg Alexander Bendrick Preventive Medicine 4822 Mckay Ave, Nasa Dryden Flight Research Center, Edwards, CA 93523 2010-04-02
1740437425 Norman Franklin Seidenverg Preventive Medicine 2030 Airport Rd, Napa, CA 94558-6208 2008-08-25
1790830347 Morton Leon Gubin Preventive Medicine 210 N El Cielo Rd, Palm Springs, CA 92262-6936 2007-01-24
1275684276 Alexander Byron Galifianakis Preventive Medicine Mcas Miramar, Hmh-466, San Diego, CA 92145 2007-01-16
1932257094 Timothy Renfrew Oeltmann Preventive Medicine Marine Aircraft Group 39, Medical, Camp Pendleton, CA 92055 2007-01-08
1750449294 Sanatkumar Krishnaram Joshi Preventive Medicine 1485 Graeber Street, Suite 9 193 Medical Group, March Jarb, CA 92518-1620 2006-12-05
1184680365 Yolanta Petrofsky Preventive Medicine 2470 Hilborn Road, Suite 110, Fairfield, CA 94534 2006-04-25
1831178334 Louis George Gilleran Preventive Medicine 50 Rosecrans St, Swmi, Bldg 500 Naval Submarine Base San Diego, San Diego, CA 92106-4408 2006-01-12
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Competitor

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City EDWARDS AFB
Zip Code 93524

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Dataset Information

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.

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