BRADLEY PHILLIPS (NPI# 1245798180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245798180 |
| Entity Type | Individual |
| Full Name | BRADLEY PHILLIPS |
| Practice Address |
1100 Wilford Hall Loop Bldg 455459 Jbsa Lackland TX 78236-5638 |
| Practice Telephone | 2109169928 |
| Practice Fax Number | 2109169332 |
| Mailing Telephone | 2109169928 |
| Mailing Fax Number | 2109169332 |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2019-03-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| STUDENT IN AN ORGANIZED HEALTHCARE EDUCATION/ TRAINING PROGRAM | 39020000X | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174009856 | Bradley Nicholas Phillips | Pharmacist | 400 Celebration Pl Ste 110, Celebration, FL 34747-4970 | 2018-07-16 |
| 1831339464 | Bradley Phillips | Pharmacist | 260 W 54th St, Apt 25b, New York, NY 10019-5539 | 2009-02-22 |
| 1235419219 | Bradley M Phillips | Pharmacist | 601 S County Farm Rd, T-0838, Wheaton, IL 60187-4529 | 2011-08-23 |
| 1649598020 | Bradley D Phillips | Physical Therapist | 1275 N Convent St, Suite 3, Bourbonnais, IL 60914-8210 | 2010-05-11 |
| 1053434498 | Bradley L Phillips | Dentist | 2018 Rock Spring Rd, Forest Hill, MD 21050-2631 | 2007-04-09 |
| 1659466449 | Bradley J Phillips | Surgery | 601 N 30th St, Suite 2803, Omaha, NE 68131-2128 | 2006-10-04 |
| 1104800143 | Bradley J. Phillips | Ophthalmology | 450 Clarkson Ave, Suite J, Brooklyn, NY 11203-2056 | 2005-12-02 |
| Street Address |
1100 WILFORD HALL LOOP BLDG 455459 |
| City | JBSA LACKLAND |
| State | TX |
| Zip Code | 78236-5638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679800734 | Dawn A Tanner | Social Worker | 1100 Wilford Hall Loop Bldg 455459, Jbsa Lackland, TX 78236 | 2009-11-11 |
| 1245855535 | David Sager | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg 455459, Jbsa Lackland, TX 78236-5638 | 2020-06-11 |
| 1629607296 | Deonte Williams | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg 455459, Jbsa Lackland, TX 78236-5638 | 2020-04-06 |
| 1609432657 | Alyssa V Joiner | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg 455459, Jbsa Lackland, TX 78236-5638 | 2019-05-15 |
| 1366900144 | Liezl Zeeman | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg 455459, Jbsa Lackland, TX 78236-5638 | 2019-03-11 |
| 1538627005 | Cameron John Elward | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg 455459, Jbsa Lackland, TX 78236-5638 | 2019-03-04 |
| 1386136299 | Lindsay Erin Gilmore | General Practice | 1100 Wilford Hall Loop Bldg 455459, Jbsa Lackland, TX 78236-5638 | 2018-06-06 |
| 1467944488 | Marie Black | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg 455459, Jbsa Lackland, TX 78236-5638 | 2018-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
| 1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
| 1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
| 1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
| 1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
| 1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
| 1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
| 1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
| 1376906958 | David Kephart Jr. | General Practice | 1100 Wilford Hall Loop Bldg 4454, Jbsa Lackland, TX 78236 | 2016-04-01 |
| 1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
| Find all providers in zip 78236 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770112534 | Michael Saunders | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop, Bldg. 4554, 59 Mdw/gme, Jbsa Lackland, TX 78236-9908 | 2020-04-03 |
| 1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
| 1659998052 | Stacy Cook | Student in an Organized Health Care Education/Training Program | Wilford Hall Ambulatory Surgical Center, 1100 Wilford Hall Loop, Bldg. 4554, 59 Mdw/gme, Jbsa Lackland, TX 78236-9908 | 2020-07-01 |
| 1245855535 | David Sager | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg 455459, Jbsa Lackland, TX 78236-5638 | 2020-06-11 |
| 1598385742 | Tora Jean Tornbom | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop, Bldg 4554, 59 Mdw/gme, Jbsa Lackland, TX 78236-5638 | 2020-04-17 |
| 1326667783 | Shreena Reddy | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 | 2020-04-15 |
| 1063031979 | Reid Hlavka | Student in an Organized Health Care Education/Training Program | Whasc, 1100 Wilford Hall Loop, Bldg. 4554, 59 Mdw/gme, Jbsa Lackland, TX 78236-9908 | 2020-04-10 |
| 1376162214 | Antonia Myers-burton | Student in an Organized Health Care Education/Training Program | Wilford Hall Ambulatory Surgical Center, 1100 Wilford Hall Loop, Bldg. 4554, 59, Mdw/gme, Jbsa Lackland, TX 78236-9908 | 2020-04-10 |
| 1114556685 | Magin Day | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 | 2020-04-06 |
| 1972132595 | Samantha Nicole Rowden | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop, Bldg 4554, 59 Mdw/gme, Jbsa Lackland, TX 78236-9908 | 2020-04-06 |
| Find all providers in JBSA LACKLAND | ||||
| City | JBSA LACKLAND |
| Zip Code | 78236 |
Please comment or provide details below to improve the information on BRADLEY PHILLIPS.
| 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.