DR. JOSE CALIXTO DE LA PENA (NPI# 1154391977) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154391977 |
| Entity Type | Individual |
| Full Name | DR. JOSE CALIXTO DE LA PENA |
| Credential | MD |
| Practice Address |
5722 Intergrity Dr. Blgd S771 (nbhc Midsouth Millington TN 38054 |
| Mailing Address |
4566 Nob Hill Dr. Arlington TN 38002-5150 |
| Practice Telephone | 9018746143 |
| Mailing Telephone | (901) 249-7356 |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 00053436 | TN | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| Naval Hospital Cherry Point, 4389 Beaufort Rd., Cherry Point, NC 28533 | 2524660182 |
| Street Address |
5722 INTERGRITY DR. BLGD S771 (NBHC MIDSOUTH |
| City | MILLINGTON |
| State | TN |
| Zip Code | 38054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073137758 | Stephanie Nicole Zuckerman | Psychologist | Intrepid Street, Bldg. S-771, Millington, TN 38054 | 2020-05-29 |
| 1992243000 | Paul Livernois | Pharmacist | S-752 Tarawa Ave, Millington, TN 38054 | 2017-02-09 |
| 1962751149 | Megan Nicole Seay Shelton | Dentist | 5722 Integrity Drive Building S-771, Millington, TN 38054 | 2012-09-05 |
| 1710208178 | Michael W Johns | Family Medicine | 5722 Intregrity Dr. Bldg. S771, Branch Medical Clinic Nsa Mid-south, Millington, TN 38054 | 2010-06-18 |
| 1053526996 | Ira N.b. Davis | Optometrist | Nex - Midsouth, Bldg S752, Millington, TN 38054 | 2007-05-14 |
| 1487746236 | Robert Dennis Preston Jr. | Military Health Care Provider | Brach Medical Clinic, Naval Support Activity Mid-south, Millington, TN 38054 | 2006-09-29 |
| 1366486086 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | Nex - Navy Support Activity - Memphis, Bldg. S752, Millington, TN 38054 | 2006-06-15 |
| 1710948245 | James R Luedtke | Technician, Other | 5722 Integrity Drive, Bldg S771, Nbhc, Nsa Mid-south, Millington, TN 38054 | 2006-04-02 |
| 1316915333 | Charles Barry Collier | Military Health Care Provider | Branch Medical Clinic, Nsa Mid South, 5722 Integrity Dr Bldg, Millington, TN 38054 | 2006-03-08 |
| 1003891490 | Thomas Mitchell Prater | Dentist | 5722 Integrity Drive, Bldg. S771, Millington, TN 38054 | 2005-12-08 |
| Find all providers in zip 38054 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275977340 | Robert Coburn Kingsbury | Family Medicine | 226 Lakeside Dr., Millington, MD 21651 | 2013-04-19 |
| 1710208178 | Michael W Johns | Family Medicine | 5722 Intregrity Dr. Bldg. S771, Branch Medical Clinic Nsa Mid-south, Millington, TN 38054 | 2010-06-18 |
| 1932258787 | Mid South Wellness Center, Inc | Family Medicine | 7662 Highway 51north, Suite 2, Millington, TN 38053 | 2007-01-10 |
| 1982767984 | Walter Elias IIi | Family Medicine | 5722 Integrity Drive Bldg. S771, Officer In Charge Branc, Millington, TN 38054-5021 | 2006-12-19 |
| 1417056409 | Samya Varuschka Cruz | Family Medicine | 5722 Integrity Dr Bldg 771, Millington, TN 38054-5028 | 2006-09-22 |
| 1023110780 | Sridhar A Rao | Family Medicine | 9030 State Rd, Millington, MI 48746-8902 | 2006-09-02 |
| 1740239490 | Catherine Jean Flowitt | Family Medicine | 5101 Thompson St, Millington, TN 38053-2458 | 2006-05-09 |
| 1588656730 | Toby Eric Anderson | Family Medicine | 9705 Oglesby Rd, Millington, TN 38053-4304 | 2005-08-15 |
| 1891205746 | Sheketa Lane | Family Medicine | 8188 Us Highway 51 N, Millington, TN 38053-1750 | 2017-10-05 |
| 1588116891 | Hamad Ahmad Md PC | Family Medicine | 4772 Navy Rd, Suite A, Millington, TN 38053-1927 | 2016-11-03 |
| Find all providers in MILLINGTON | ||||
| City | MILLINGTON |
| Zip Code | 38054 |
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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.