DR. JAY STEFAN GORBAN (NPI# 1265408744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265408744 |
| Entity Type | Individual |
| Full Name | DR. JAY STEFAN GORBAN |
| Credential | PHD |
| Practice Address |
650 Joel Dr Blanchfield Army Community Hospital Ft. Campbell KY 42223-5349 |
| Practice Telephone | 2707988372 |
| Mailing Telephone | 2707988372 |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
718 | KY | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
686 | TN | Behavioral Health & Social Service Providers |
| Street Address |
650 JOEL DR BLANCHFIELD ARMY COMMUNITY HOSPITAL |
| City | FT. CAMPBELL |
| State | KY |
| Zip Code | 42223-5349 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649464264 | Daniel Francis Comeaux | Physician Assistant | 650 Joel Dr, Blanchfield Army Community Hospital, Ft. Campbell, KY 42223-5349 | 2007-08-28 |
| 1114092301 | Mark D Krueger | Pharmacist | 650 Joel Dr, Blanchfield Army Community Hospital, Ft. Campbell, KY 42223-5349 | 2006-11-22 |
| 1144395534 | Sherry L Fanara | Counselor | 650 Joel Dr, Blanchfield Army Community Hospital, Ft. Campbell, KY 42223-5349 | 2006-11-21 |
| 1326113812 | Sherry L Hedrick | Physician Assistant | 650 Joel Dr, Blanchfield Army Community Hospital, Ft. Campbell, KY 42223-5349 | 2006-11-21 |
| 1720153117 | Whitney A Devers | Psychologist | 650 Joel Dr, Blanchfield Army Community Hospital, Ft. Campbell, KY 42223-5349 | 2006-11-21 |
| 1477628865 | Robert J Crouch IIi | Physician Assistant | 650 Joel Dr, Blanchfield Army Community Hospital, Ft. Campbell, KY 42223-5349 | 2006-11-21 |
| 1063479046 | Kathy L Morgan | Licensed Practical Nurse | 650 Joel Dr, Blanchfield Army Community Hospital, Ft. Campbell, KY 42223 | 2006-04-26 |
| 1871569178 | David Edward Mendoza | Pathology | 650 Joel Dr, Blanchfield Army Community Hospital, Ft. Campbell, KY 42223-5349 | 2006-02-27 |
| 1790751022 | Phillip Daniel Brooks | Radiology | 650 Joel Dr, Blanchfield Army Community Hospital, Ft. Campbell, KY 42223-5349 | 2006-02-27 |
| 1801862164 | Mark Trawinski | Family Medicine | 650 Joel Dr, Blanchfield Army Community Hospital, Ft. Campbell, KY 42223-5349 | 2006-02-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558978825 | Eden Addisu Kebede | Social Worker | Ft. Campbell/bach, 650 Joel Drive, Fort Campbell, KY 42223 | 2020-09-30 |
| 1174134662 | Lucas Pepper | Dentist | Desert Storm Ave, Bldg 5580, Apo, AA 42223 | 2020-08-10 |
| 1639711203 | Travis Robert Bryant | Optometrist | 5979 Desert Storm Ave., Lapointe Health Clnic Optometry, Ft. Campbell, KY 42223 | 2019-10-15 |
| 1184138232 | Vanessa Renee Simmons | Dental Assistant | 302b Baker St, Fort Campbell, KY 42223 | 2017-11-28 |
| 1922451996 | Isabella Julson | Dental Assistant | Bldg2441 21st Street, Us Army Dental Activity, Fort Campbell, KY 42223 | 2016-07-14 |
| 1336595305 | Heidi Cameron | Acupuncturist | 2889b Idaho Avenue, Fort Campbell, KY 42223 | 2016-05-10 |
| 1649644154 | Nathan Silvey | Physician Assistant | Building 4179, Fort Campbell, KY 42223 | 2015-11-20 |
| 1396145306 | Blanchfield Army Community Hospital | Clinic/Center | Bldg 2403, Air Assault St and Indiana Ave, Fort Campbell, KY 42223 | 2014-08-27 |
| 1275948564 | Rodney C Merkley | Psychologist | Building 3929, Ft. Capmbell, KY 42223 | 2014-06-25 |
| 1659785053 | Blanchfield Army Community Hospital | Clinic/Center | Bldg 6747 A Shau Valley Road, Fort Campbell, KY 42223 | 2014-06-13 |
| Find all providers in zip 42223 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992852453 | Jason B Deleeuw | Psychologist | 650 Joel Dr., Blanchfield Army Community Hospital, Ft. Campbell, KY 42223-5349 | 2007-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700486230 | Angie Fabiola Hernandez | Psychologist | 1009 Fisk Ct, Lexington, KY 40511-8369 | 2020-10-26 |
| 1548869084 | Skaggs Consulting, Pllc | Psychologist | 501 Darby Creek Rd Ste 41, Lexington, KY 40509-1671 | 2020-10-24 |
| 1467050856 | Tyler J Ryan | Psychologist | 4220 Houston Rd, Erlanger, KY 41018-3402 | 2020-10-16 |
| 1801412424 | Melinda Moore | Psychologist | 144 E Lowry Ln, Lexington, KY 40503-2403 | 2020-06-19 |
| 1396377164 | Mariya Leyderman | Psychologist | 974 Breckenridge Ln # 171, Louisville, KY 40207-4619 | 2020-02-10 |
| 1841821196 | Sally Losson Brenzel | Psychologist | 10503 Timberwood Cir Ste 205, Louisville, KY 40223-5395 | 2020-01-27 |
| 1760948939 | True North Counseling & Development, Pllc | Psychologist | 2220 Executive Dr Ste 202, Lexington, KY 40505-4872 | 2019-02-13 |
| 1871057042 | Brame Psychological Assessment Center | Psychologist | Ray and Kay Eckstein Outreach Center, 435 Berger Rd, Paducah, KY 42003 | 2019-01-22 |
| 1902377864 | Green Meadows Wellness Center One, LLC | Psychologist | 1640 Meadow Creek Rd, Rockholds, KY 40759-9563 | 2018-12-17 |
| 1093299299 | Kallye Joanah Renner | Psychologist | 7426 Us 42 Ste 106, Florence, KY 41042-2056 | 2018-09-24 |
| Find all providers with the same taxonomy | ||||
| City | FT. CAMPBELL |
| Zip Code | 42223 |
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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.