KELLY L. RIEGLEMAN (NPI# 1215396072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215396072 |
| Entity Type | Individual |
| Full Name | KELLY L. RIEGLEMAN |
| Other Name | KELLY J LAURENT |
| Credential | MD |
| Practice Address |
221 3rd St W Randolph Afb TX 78150-4800 |
| Mailing Address |
221 3rd St W Jbsa Randolph TX 78150-4800 |
| Practice Telephone | 2106524267 |
| Mailing Telephone | 2106524267 |
| Enumeration Date | 2016-02-22 |
| Last Update Date | 2019-09-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 30231 | NE | Allopathic & Osteopathic Physicians |
| Street Address |
221 3RD ST W |
| City | RANDOLPH AFB |
| State | TX |
| Zip Code | 78150-4800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780228015 | Garrett R Lyman | Physician Assistant | 221 3rd St W, Randolph Afb, TX 78150-4800 | 2019-10-30 |
| 1972074102 | Alexander Louis Nestor | Military Health Care Provider | 221 3rd St W, Randolph Afb, TX 78150-4800 | 2018-12-16 |
| 1861973349 | Kimberli M Molina | Physician Assistant | 221 3rd St W, Randolph Afb, TX 78150-4800 | 2018-08-23 |
| 1225526668 | Jon Paul Fitzgerald | Military Health Care Provider | 221 3rd St W, Randolph Afb, TX 78150-4800 | 2018-05-01 |
| 1326587494 | Jonathan Madden | Military Health Care Provider | 221 3rd St W, Randolph Afb, TX 78150 | 2017-02-22 |
| 1508308685 | Stephanie Jean Campos | Registered Nurse | 221 3rd St W, Randolph Afb, TX 78150 | 2016-11-07 |
| 1568915643 | Shanna Leah Irizarry-miller | Nurse Practitioner | 221 3rd St W, Randolph Afb, TX 78150 | 2016-07-26 |
| 1982086807 | David Brockbank | Dentist | 221 3rd St W, Randolph Afb, TX 78150 | 2015-06-27 |
| 1528488558 | Maxwell Dickey | Preventive Medicine | 221 3rd St W, Randolph Afb, TX 78150-4800 | 2014-04-17 |
| 1740619923 | Michael Prater | Pharmacist | 221 3rd St W, Bldg 1040 Rm 1d201, Randolph Afb, TX 78150-4800 | 2013-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770045833 | Erica Renae Guevara | Physician Assistant | 559 Medial Sq, 221 Third Street West Bldg. 1040, Jbsa-randolph Afb, TX 78150 | 2019-04-05 |
| 1457803868 | Emily Newman | Dietitian, Registered | 221 Third Street West, Bldg. 999 Ste 2, Joint Base San Antonio -randolph, TX 78150 | 2016-11-02 |
| 1922411677 | Amber Drewer | Military Health Care Provider | 3rd Street West Building 1040, Randolph Afb, TX 78150 | 2014-06-10 |
| 1144652975 | Josephine Kimberly Olsen | Family Medicine | 359 Mdos/mdg, Randolph Afb, TX 78150 | 2013-08-02 |
| 1609149681 | Lucky Lusterio | Preventive Medicine | 221 3rd St. W, Randolph Afb, TX 78150 | 2012-02-21 |
| 1417120569 | Joni Hodgson | General Practice | 221 3rd Street West, Jbsa Randolph, TX 78150 | 2008-04-09 |
| 1710095724 | Katherine Justen Adamson | Physician Assistant | 12th Medical Group, 221 3rd Street West, Randolph Air Force Base, TX 78150 | 2006-08-29 |
| 1811950090 | Lidia Stana Ilcus | Internal Medicine | 359 Mdg, 221 Third Street West, Randolph Afb, TX 78150 | 2006-04-10 |
| 1013970672 | David Hamilton | Social Worker | 12mdos/sgohf, Randolph Afb, TX 78150 | 2006-04-06 |
| 1962465526 | Robert Allan Briggs | Physical Therapist | Randolph Afb Clinic, 221 3rd St W, Randolph Afb, TX 78150 | 2006-04-06 |
| Find all providers in zip 78150 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790241487 | Charisse Brown-moran | General Practice | 221 3rd St W Bldg 1040, Randolph Afb, TX 78150-4800 | 2019-02-18 |
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| Find all providers with the same taxonomy | ||||
| City | RANDOLPH AFB |
| Zip Code | 78150 |
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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.