JEFFRY METHENY (NPI# 1205822947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205822947 |
| Entity Type | Individual |
| Full Name | JEFFRY METHENY |
| Credential | M.D. |
| Practice Address |
635 Anderson Rd #18 Davis CA 95616-3505 |
| Practice Telephone | 5307714000 |
| Practice Fax Number | 5307714011 |
| Mailing Telephone | 5307714000 |
| Mailing Fax Number | 5307714011 |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2007-07-08 |
| NPI Deactivation Date | 03/27/2006 |
| NPI Reactivation Date | 2006-03-31 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | G564650 | CA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G564650 | 05 |
| Street Address |
635 ANDERSON RD #18 |
| City | DAVIS |
| State | CA |
| Zip Code | 95616-3505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235135427 | Tracy Lee Basso | Podiatrist | 635 Anderson Rd, Ste 19, Davis, CA 95616-3505 | 2005-06-22 |
| 1194258293 | Tyler Poland | Chiropractor | 635 Anderson Rd, Ste 14, Davis, CA 95616-3505 | 2017-04-05 |
| 1487010062 | Scott Vermeulen | Orthotist | 635 Anderson Rd, Suite 18, Davis, CA 95616-3505 | 2016-01-12 |
| 1174909402 | Hanger Prosthetics & Orthotics West, Inc. | Durable Medical Equipment & Medical Supplies | 635 Anderson Rd, Suite 18, Davis, CA 95616-3505 | 2015-08-10 |
| 1891058962 | David Lee Tomkins | Family Medicine | 635 Anderson Rd, Suite 10, Davis, CA 95616-3505 | 2012-06-22 |
| 1922382316 | Hong Joon Lee | Acupuncturist | 635 Anderson Rd, Suite 12a, Davis, CA 95616-3505 | 2011-10-04 |
| 1013143718 | Crystal Blankenship | Family Medicine | 635 Anderson Rd, Suite 10, Davis, CA 95616-3505 | 2009-06-09 |
| 1932364163 | Laura H Applebaum | Family Medicine | 635 Anderson Rd, Suite 10, Davis, CA 95616-3505 | 2008-07-28 |
| 1750559928 | Sutter Health | Non-Pharmacy Dispensing Site | 635 Anderson Rd, 10, Davis, CA 95616-3505 | 2008-02-11 |
| 1194891747 | Sutter Medical Foundation | Durable Medical Equipment & Medical Supplies | 635 Anderson Rd, #10, Davis, CA 95616-3505 | 2006-11-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560871 | Anne-frances Ostrander | Physical Therapy Assistant | 397 La Rue Rd, Davis, CA 95616 | 2020-08-26 |
| 1487271458 | Alix Peloso Mahon | Behavior Technician | 1212 Alvarado Ave Apt 68, Davis, CA 95616 | 2020-06-25 |
| 1427671882 | Dhhs Ihs Cao Sacred Oaks Healing Center | Substance Abuse Rehabilitation Facility | 33100 County Road 31, Davis, CA 95616 | 2020-05-20 |
| 1871126961 | Linda Marie Adams | Dietitian, Registered | Uc Davis Occupational Health, One Shields Ave - Cowell Hall Room 35, Davis, CA 95616 | 2020-02-17 |
| 1851935217 | Timothy James Johnston | Orthotist | 635 Anderson Rd., Suite 18, Davis, CA 95616 | 2019-10-29 |
| 1386290716 | Dakota Cool | Specialist/Technologist | 750 Orchard Road, Davis, CA 95616 | 2019-08-12 |
| 1366908618 | Capitol Periodontal Group | Dentist | 750 F Street #5, Davis, CA 95616 | 2019-02-12 |
| 1831663434 | Elisha Niccole Cusumano | Specialist/Technologist | 264 Hickey Gym, 1 Shields Ave, Davis, CA 95616 | 2019-01-16 |
| 1609364991 | Aron Matthew Katz | Psychologist | One Shield Ave, Student Health & Wellness Center, Bhp, Davis, CA 95616 | 2018-04-23 |
| 1316463938 | Arielle Pinkston | Marriage & Family Therapist | 203 F St, Davis, CA 95616 | 2017-08-15 |
| Find all providers in zip 95616 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699982389 | Christinea Marie Bellin | Specialist | 2604 Hartley St, Davis, CA 95616-7632 | 2007-05-16 |
| 1730293309 | Sacramento Heart & Vascular | Specialist | 1111 Kennedy Pl Ste 1, Davis, CA 95616-1266 | 2006-08-19 |
| 1386694404 | Lawrence S Paikoff | Specialist | 1712 Picasso Ave, #c, Davis, CA 95616-0546 | 2006-05-11 |
| 1285619296 | Renuka Lakshminarayanan | Specialist | 3002 Breton Ave, Davis, CA 95616-2706 | 2005-12-13 |
| 1407838782 | Brian Robert Wilson | Specialist | 2020 Sutter Pl Ste 203, Davis, CA 95616-6201 | 2005-11-14 |
| 1962948372 | Elyse Lauren Byrum | Specialist | 212 I St, Davis, CA 95616-4213 | 2017-01-09 |
| 1467906222 | Duane Robinson | Specialist | 1 Shields Ave, School of Vet Med, Uc Davis, Davis, CA 95616-5270 | 2016-08-10 |
| 1417308321 | Permanente Medical Group | Specialist | 1955 Cowell Blvd, Davis, CA 95618-6325 | 2016-06-22 |
| 1669858817 | Davis Urgent Care Inc. | Specialist | 4515 Fermi Pl, Suite 105, Davis, CA 95618-9410 | 2015-08-10 |
| 1891058947 | Stephanie J Lake | Specialist | One Shields Ave, Uc Davis Student Health and Couseling Services, Davis, CA 95616 | 2012-06-22 |
| Find all providers in DAVIS | ||||
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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.