JESMOND RIDGE MEDICAL SERVICES A MEDICAL CORPORATION (NPI# 1194251595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194251595 |
| Entity Type | Organization |
| Organization Name | JESMOND RIDGE MEDICAL SERVICES A MEDICAL CORPORATION |
| Practice Address |
525 W Acacla St Stockton CA 95203 |
| Mailing Address |
13737 Noel Rd 1600 Dallas TX 75240-1331 |
| Practice Telephone | 4694012386 |
| Mailing Telephone | 9548382371 |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2019-10-23 |
| Authorized Official Name | KATHLEEN KONDAS (VP PROVIDER ENROLLMENT) |
| Authorized Official Telephone | 9732511132 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
525 W ACACLA ST |
| City | STOCKTON |
| State | CA |
| Zip Code | 95203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447899349 | Sagrario Alva Chavez | Technician | Sagrario Chavez, 1248 West Park St., Stockton, CA 95203 | 2019-12-26 |
| 1538682810 | Kumars Transport | Non-emergency Medical Transport (VAN) | 1112 W Fremont St, Stockton, CA 95203 | 2017-07-19 |
| 1285011064 | Brian Andrew Reuter | Emergency Medicine | Dameron Hospital, 525 Acacia St, Stockton, CA 95203 | 2015-04-30 |
| 1548209240 | Aaron James Simko | Pediatrics | 525 Acacia Street, Neonatal Department, Stockton, CA 95203 | 2006-06-06 |
| 1881057461 | El Concilio | Case Management | 445 N San Joaquin St, Stockton, CA 95203 | 2016-04-01 |
| 1619350634 | Sudha Vani Saduvala | Internal Medicine | 525 W Acacia St, Stockton, CA 95203 | 2015-07-08 |
| 1740621671 | Syed Salman Ali | Internal Medicine | 525 W Acacia St, Stockton, CA 95203 | 2013-07-08 |
| 1417021726 | Sahir Naseer | Emergency Medicine | 525 W Acacia St, Stockton, CA 95203 | 2006-11-20 |
| 1104312800 | Melissa Delossantos | Behavioral Analyst | 2180 Lucerne Ave, Stockton, CA 95203-1257 | 2018-07-05 |
| 1487019568 | Evelyn Marie Cabral | Registered Nurse | 1966 W Rose St, Stockton, CA 95203-1327 | 2015-12-16 |
| Find all providers in zip 95203 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285011064 | Brian Andrew Reuter | Emergency Medicine | Dameron Hospital, 525 Acacia St, Stockton, CA 95203 | 2015-04-30 |
| 1336192582 | Rodger S Campbell | Emergency Medicine | 106 West Blair Drive, Stockton, MO 65785 | 2006-05-18 |
| 1871082917 | Christine Elizabeth Ren | Emergency Medicine | 1800 N California St, Stockton, CA 95204-6019 | 2018-05-03 |
| 1588168793 | Samuel Richard Kaplan | Emergency Medicine | 1800 N California St, Stockton, CA 95204-6019 | 2018-03-21 |
| 1497286306 | Grace Rodriguez | Emergency Medicine | 525 W Acacia St, Stockton, CA 95203-2405 | 2017-03-22 |
| 1831553171 | Zachary Carl Haberman | Emergency Medicine | 1800 N California St, Stockton, CA 95204-6019 | 2016-04-13 |
| 1831571785 | Tatiana Thema | Emergency Medicine | 525 W Acacia St, Stockton, CA 95203-2405 | 2015-06-26 |
| 1194116459 | Gary Scott Olds | Emergency Medicine | 1800 N California St, Stockton, CA 95204-6019 | 2015-02-09 |
| 1568877728 | Luis Armando Melendez Serrano | Emergency Medicine | 525 W Acacia St, Stockton, CA 95203-2405 | 2014-06-26 |
| 1518222876 | Denise Louise Ammon | Emergency Medicine | 1800 N California St, Stockton, CA 95204-6019 | 2012-07-11 |
| Find all providers in STOCKTON | ||||
Please comment or provide details below to improve the information on JESMOND RIDGE MEDICAL SERVICES A MEDICAL CORPORATION.
| 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.