JESSY EUGENE WARREN WHITTALL (NPI# 1194377903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194377903 |
| Entity Type | Individual |
| Full Name | JESSY EUGENE WARREN WHITTALL |
| Practice Address |
4389 Beafort Rd Havelock NC 28532 |
| Mailing Address |
4389 Beaufort Rd Havelock NC 28532 |
| Practice Telephone | 2524660921 |
| Mailing Telephone | 2524660921 |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2019-07-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| Street Address |
4389 BEAFORT RD |
| City | HAVELOCK |
| State | NC |
| Zip Code | 28532 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194341396 | Tara-dawm R Tootle | Pharmacist | 1204 E Mail St, Havelock, NC 28532 | 2020-06-23 |
| 1508375676 | Lacey Leeann Robinson | Dentist | 610 Miller Boulevard, Havelock, NC 28532 | 2017-09-21 |
| 1053861112 | Adam Toliver Davis | Dentist | 502 Us Hwy 70 West, Havelock, NC 28532 | 2016-10-12 |
| 1467825331 | Stephany Agudelo | Social Worker | 102 Verona Dive, Havelock, NC 28532 | 2015-11-02 |
| 1386089225 | Joanna Tiaira Johnson | Nurse Practitioner | 4389 Beaufort, Havelock, NC 28532 | 2013-05-06 |
| 1962665653 | Coastal Childrens Clinic | Pediatrics | 218 Stone Bridge Square, Havelock, NC 28532 | 2008-07-03 |
| 1235325218 | Michelle Land Amber | Dietitian, Registered | 210 Stonebridge Square, Havelock, NC 28532 | 2007-09-24 |
| 1437217213 | Havelock Chiropractic Center P.a. | Chiropractor | 314 Highway 70 West, Havelock, NC 28532 | 2006-12-05 |
| 1831273127 | David Lee Woodward Jr. | Chiropractor | 314 Hwy. 70 West, Havelock, NC 28532 | 2006-10-24 |
| 1316031602 | William S Harvey IIi | Dentist | 92 Stonebridge Trail, Havelock, NC 28532 | 2006-10-03 |
| Find all providers in zip 28532 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811391006 | Patrick Edward Goldsmith | Military Health Care Provider | 100 Roosevelt Blvd, Mcas Cherry Point, Havelock, NC 28533 | 2014-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820002 | Levi Para | Military Health Care Provider | 2d Reconnaissance Bn, Psc 20138, Camp Lejeune, NC 28452-0138 | 2020-10-29 |
| 1427661743 | Russ C Garlinghouse | Military Health Care Provider | Rr 616, Stone Bay, NC 28460 | 2020-08-26 |
| 1164033197 | Brian David Bjerke | Military Health Care Provider | 612 Everrett Creek Road, Snead's Ferry, NC 28460 | 2020-08-13 |
| 1588274641 | Adam Randolph Smith | Military Health Care Provider | 205 Wintergreen Ln, Hubert, NC 28539-4659 | 2020-08-04 |
| 1588273999 | Jacob Johnson | Military Health Care Provider | 413 Salvo Ct, Holly Ridge, NC 28445-8609 | 2020-07-31 |
| 1790309565 | Jason C Smith | Military Health Care Provider | 113 Barrington Ct, Maple Hill, NC 28454-8659 | 2020-06-08 |
| 1639793748 | Johnathon T Brewer | Military Health Care Provider | 100 White St, Jacksonville, NC 28540 | 2020-06-04 |
| 1003444928 | Andres Martin Rodoni | Military Health Care Provider | 2nd Reconnaissance Battalion, Camp Lejune, NC 28542 | 2020-03-27 |
| 1699306670 | Dominick Ciampo | Military Health Care Provider | A66 Boat Basin Road, Camp Lejeune, NC 28542 | 2020-01-29 |
| 1487294682 | Daniel Scott Porterfield | Military Health Care Provider | Building Rr612, Loop Rd, Sneads Ferry, NC 28460 | 2020-01-15 |
| 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.