DR. JIMMY DEAN CHUBBUCK (NPI# 1285857136) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285857136 |
| Entity Type | Individual |
| Full Name | DR. JIMMY DEAN CHUBBUCK |
| Credential | M.D. |
| Practice Address |
2120 Ryan Rd Buckley WA 98321-9115 |
| Mailing Address |
2096 Ryan Rd Buckley WA 98321-9115 |
| Practice Telephone | 3608291111 |
| Mailing Telephone | 3608296304 |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2012-11-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 20387 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1189107 | 05 |
| Street Address |
2120 RYAN RD |
| City | BUCKLEY |
| State | WA |
| Zip Code | 98321-9115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679650576 | Ebrahim Mirjalili | Dentist | 2120 Ryan Rd, Buckley, WA 98321 | 2006-11-01 |
| 1639770373 | Hye Jin Kim | Nurse Practitioner | 2120 Ryan Rd, Buckley, WA 98321-9115 | 2020-11-07 |
| 1205434701 | Deidre Ann Mance | Nurse Practitioner | 2120 Ryan Rd, Buckley, WA 98321-9115 | 2020-10-15 |
| 1164547626 | Rainier State School | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2120 Ryan Rd, Buckley, WA 98321-9115 | 2007-03-20 |
| 1710017736 | James Thomas Raugust | Dentist | 2120 Ryan Rd, Buckley, WA 98321-9115 | 2007-03-07 |
| 1528197340 | Sherri Elizabeth Barrett | Physical Medicine & Rehabilitation | 2120 Ryan Rd, Buckley, WA 98321-9115 | 2007-03-05 |
| 1124160148 | Adam John Tabet | Psychiatry & Neurology | 2120 Ryan Rd, Buckley, WA 98321-9115 | 2007-02-13 |
| 1740355320 | Washington State Department of Social and Health Services | Pharmacy | 2120 Ryan Rd, Buckley, WA 98321-9115 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598308397 | Melanie Tison | Licensed Practical Nurse | 340 White River Park Rd, Buckley, WA 98321 | 2019-10-24 |
| 1164918850 | Desiree Helfrick | Counselor | 117 S Cedar St, Suite 2, Buckley, WA 98321 | 2018-07-05 |
| 1962925206 | Karen Anne Smith | Counselor | 240 A St. N, Buckley, WA 98321 | 2017-07-19 |
| 1992227375 | Clb Pharmaceutical Resources Inc | Public Health or Welfare | 22712 78th St. E, Buckley, WA 98321 | 2017-07-07 |
| 1922547231 | Kathryn Zawislak | Counselor | 117 S Cedar St, Suite 2, Buckley, WA 98321 | 2017-02-20 |
| 1336525443 | Jennifer Cochrane-nicolls | Social Worker | 117 S. Cedar St., Suite 2, Buckley, WA 98321 | 2015-07-31 |
| 1427399013 | Karis Ann Roberts | Occupational Therapy Assistant | 130 S Cottage St, Buckley, WA 98321 | 2013-03-07 |
| 1235495433 | Michael Leigh Beall | Chiropractor | 766 Main St, Buckley, WA 98321 | 2012-04-02 |
| 1720395601 | Jared Stephen Bleasdale | Massage Therapist | 280 C Street, Buckley, WA 98321 | 2010-09-13 |
| 1164630620 | Sandra T Bittner | Massage Therapist | 700 Main St P, Buckley, WA 98321 | 2007-05-18 |
| Find all providers in zip 98321 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649394800 | White River Family Care LLC | Family Medicine | 305 N.river Ave., Buckley, WA 98321 | 2007-03-16 |
| 1235122763 | Michael A Welsh | Family Medicine | 305 N River Ave, Buckley, WA 98321-8978 | 2005-08-30 |
| 1861568479 | Mitzie Jean Hewitt | Family Medicine | 11293 N M-37, Suite A, Buckley, MI 49620 | 2006-11-27 |
| 1649263161 | James L Parker | Family Medicine | 305 N River Ave, Buckley, WA 98321-8978 | 2005-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063010957 | Olympic Medical Pllc | Family Medicine | 6342 Littlerock Rd Sw Bldg 3, Tumwater, WA 98512-7332 | 2020-10-13 |
| 1124631296 | Direct Care Clinics Us PC | Family Medicine | 2307 Se 3rd Circle, Suite 203, Vancouver, WA 98661-9860 | 2020-08-28 |
| 1851902605 | Northwest Clinical Services | Family Medicine | 825 Se Bishop Blvd Ste 301c, Pullman, WA 99163-5517 | 2020-08-14 |
| 1003424128 | Kelly P Grenner | Family Medicine | 15424 Ne 160th St, Woodinville, WA 98072-8180 | 2020-07-14 |
| 1851919476 | Thuthi Enterprises, LLC | Family Medicine | 715 N Park Ctr # A, Selah, WA 98942-1174 | 2020-07-09 |
| 1851917074 | Kaiser Foundation Health Plan of Washington | Family Medicine | 5216 Point Fosdick Dr # 102, Gig Harbor, WA 98335-0037 | 2020-06-23 |
| 1245856830 | Jackie C Toh | Family Medicine | 13684 18th Ave Sw, Burien, WA 98166-1047 | 2020-06-19 |
| 1669097127 | Dawnmd LLC | Family Medicine | 540 E Main St Ste A, Pullman, WA 99163-2660 | 2020-06-10 |
| 1427672310 | Andrea Lauren Cistulli | Family Medicine | 3619 Talbot Rd S Ste 401, Renton, WA 98055-5708 | 2020-06-05 |
| 1114540457 | Country Doctor Community Clinic | Family Medicine | 2410 E Cherry St, Seattle, WA 98122-4832 | 2020-05-21 |
| 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.