MR. JOSE VICTOR NAZARIO (NPI# 1184850760) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184850760 |
| Entity Type | Individual |
| Full Name | MR. JOSE VICTOR NAZARIO |
| Credential | IDMT |
| Practice Address |
628 Ed Moye Rd La Grange NC 28551-8888 |
| Practice Telephone | 2402163247 |
| Mailing Telephone | 2402163247 |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2010-11-16 |
| 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 |
| Street Address |
628 ED MOYE RD |
| City | LA GRANGE |
| State | NC |
| Zip Code | 28551-8888 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992229215 | Christopher Webster | Physical Therapist | 3870 Falling Creek Road, Legrange, NC 28551 | 2017-07-28 |
| 1437527082 | Tanger Lee Jones | Counselor | 197 Brook Meadow Lane, Lagrange, NC 28551 | 2015-09-11 |
| 1235362161 | Daniel's Choices Youth Development, Inc. | Community/Behavioral Health | 525 Arba Jason Rd., La Grange, NC 28551 | 2009-08-26 |
| 1518942135 | Marjorie R Rachide | Nurse Practitioner | 101 South Carey Street, Lagrange, NC 28551 | 2005-12-07 |
| 1669611471 | Nova Ic, Inc. | Intermediate Care Facility, Mentally Retarded | 407 W. Washington Street, Lagrange, NC 28551-1623 | 2009-02-18 |
| 1447499330 | Nova Ic, Inc. | Intermediate Care Facility, Mentally Retarded | 405 W Washington St, La Grange, NC 28551-1623 | 2009-02-17 |
| 1629259676 | Advantage Care of North Carolina, LLC | Case Management | 111 S Caswell St, La Grange, NC 28551-1707 | 2007-11-19 |
| 1629118013 | Waters' Provider Care Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 104 W James St, La Grange, NC 28551-1727 | 2007-02-07 |
| 1568586808 | Ant Mary's Family Care | Custodial Care Facility | 127 E Railroad St, La Grange, NC 28551-1741 | 2007-03-19 |
| 1720063340 | Carl L Haynes Jr. | Family Medicine | 101 S Carey St, La Grange, NC 28551-1805 | 2005-12-07 |
| Find all providers in zip 28551 | ||||
| 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 |
|---|---|---|---|---|
| 1528415841 | Kelby Joseph Sage Durnin | Military Health Care Provider | 1020 Jabara Avenue, Seymour Johnson Afb, NC 27534 | 2016-05-17 |
| 1225425655 | Justin Wells | Military Health Care Provider | 1398 Surveyor St, Pope Army Airfield, NC 28308-2710 | 2015-04-23 |
| 1912267295 | Amber Lynn Scouton | Military Health Care Provider | 215 Bolling Dr, Goldsboro, NC 27534-5527 | 2012-05-21 |
| 1750662417 | Daryl Bradley | Military Health Care Provider | 146 Tulane Dr, Raeford, NC 28376 | 2011-09-07 |
| 1811211642 | Leasa C Novotny | Military Health Care Provider | 271 Sheridan Forest Rd Apt 1200, Goldsboro, NC 27534-7155 | 2010-03-23 |
| 1467784926 | James Blake Little | Military Health Care Provider | 300 Meadow Rd, Goldsboro, NC 27534-8759 | 2010-02-09 |
| 1710116595 | Patrick Joseph Hunt | Military Health Care Provider | 1 Matero Dr, Ol-c 342trs, Pope, NC 28308 | 2009-07-14 |
| 1962637504 | Christopher Michael Lohr | Military Health Care Provider | 102 Partridge Rd, Fayetteville, NC 28306-8235 | 2009-05-27 |
| 1417191974 | Erik William Rodriguez | Military Health Care Provider | 106 Purple Martin Pl, Fayetteville, NC 28306-8262 | 2009-04-28 |
| 1699919795 | Charles J Ross | Military Health Care Provider | 5809 Ivanhoe Ct Apt 18, Fayetteville, NC 28314-4461 | 2009-04-21 |
| Find all providers with the same taxonomy | ||||
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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.