BRANDON CHEADLE (NPI# 1457765729) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457765729 |
| Entity Type | Individual |
| Full Name | BRANDON CHEADLE |
| Credential | RADIOLOGY TECHNICIAN |
| Practice Address |
Lyster Army Health Clinic Bldg 301 Andrews Ave Fort Rucker AL 36362-5333 |
| Practice Telephone | 3342557155 |
| Mailing Telephone | 3342557155 |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2014-06-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247100000X | Radiologic Technologist | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
LYSTER ARMY HEALTH CLINIC BLDG 301 ANDREWS AVE |
| City | FORT RUCKER |
| State | AL |
| Zip Code | 36362-5333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912964115 | Wendy Ruth Campbell | Nurse Practitioner | Lyster Army Health Clinic, 301 Andrews Avenue, Fort Rucker, AL 36362 | 2006-05-01 |
| 1598311409 | Catherine Rebecca Baden | Technician | Lyster Army Health Clinic, Bldg 301 Andrews Avenue, Fort Rucker, AL 36362-5333 | 2019-08-15 |
| 1447802392 | Ginger Lynn Tanner | Registered Nurse | Lyster Army Health Clinic, Building 301 Andrews Avenue, Fort Rucker, AL 36362-5333 | 2019-07-11 |
| 1659923506 | Joni E Prugh | Physical Therapy Assistant | Lyster Army Health Clinic, Bldg 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2019-07-11 |
| 1063074805 | Crystal Harris | Emergency Medical Technician, Basic | Lyster Army Health Clinic, Bldg 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2019-07-02 |
| 1871158444 | Dorma Sanders | Registered Nurse | Lyster Army Health Clinic, Bldg 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2019-05-08 |
| 1942769047 | Emily Sue Canlas | Registered Nurse | Lyster Army Health Clinic, Bldg. 301 Andrews Ave., Fort Rucker, AL 36362-5333 | 2019-03-18 |
| 1366900821 | Michael Joseph Brown | Emergency Medical Technician, Basic | Lyster Army Health Clinic, Building 301 Andrews Avenue, Fort Rucker, AL 36362-5333 | 2019-03-04 |
| 1861956823 | Katherine Lambeth | Technician/Technologist | Lyster Army Health Clinic, Bldg 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2019-01-24 |
| 1376014480 | Patrick Gabriel Lawson | Emergency Medical Technician, Paramedic | Lyster Army Health Clinic, Bldg 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2018-12-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235745571 | Rachel Kestler | Specialist | 4102 Gadiator Street, Fort Rucker, AL 36362 | 2020-09-22 |
| 1417589268 | Jacob Michael Lezon | Emergency Medical Technician, Basic | 30501 Nevins St., Ft. Rucker, AL 36362 | 2020-02-10 |
| 1225535388 | Rhonda Lewis Wesolek | Dental Hygienist | Bldg 4405, Innkeeper Street, Fort Rucker, AL 36362 | 2018-04-06 |
| 1770013369 | National Vision, Inc. | Technician/Technologist | Bldg 9214, Fort Rucker, AL 36362 | 2017-06-15 |
| 1750730958 | Teresa Morgan Knighten | Dental Hygienist | 4405 Innkeepers St, Fort Rucker, AL 36362 | 2016-06-08 |
| 1568826246 | David Virgil II | Technician, Other | 2218 6th Avenue Building 4102, Fort Rucker, AL 36362 | 2016-04-08 |
| 1356771257 | Robert E Smith | Emergency Medical Technician, Intermediate | Blding 301 Andrew Ave, Ft Rucker, AL 36362 | 2013-11-14 |
| 1548503469 | Lindsey Taylor Mendenhall | Emergency Medical Technician, Basic | Bldg 301 Andrews Ave 1-223rd Hhc, Lyster Army Health Clinic, Fort Rucker, AL 36362 | 2013-03-28 |
| 1689913808 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | Fort Rucker Bldg. 9214, Daleville, AL 36362 | 2013-02-07 |
| 1275880205 | Sandra Lynn Griffin Banner | Optometrist | 33 Endl Ave, Fort Rucker, AL 36362 | 2012-08-09 |
| Find all providers in zip 36362 | ||||
| Taxonomy Code | 247100000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831501485 | Evangelina Perez | Radiologic Technologist | 301 Andrews Ave, Lyster Army Health Clinic Bldg, Fort Rucker, AL 36362 | 2014-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891077723 | Panya J Holmes | Radiologic Technologist | 5075 Dawes Rd, Grand Bay, AL 36541-3219 | 2011-09-16 |
| 1326066184 | David Paul Johnson | Radiologic Technologist | 12119 Us Highway 431, Guntersville, AL 35976-9344 | 2006-07-18 |
| 1003831900 | G Dwayne Gann | Radiologic Technologist | 1201 13th Ave Se, Decatur, AL 35601-4300 | 2006-07-12 |
| 1710919691 | William Richard Daniel | Radiologic Technologist | 12119 Us Highway 431 South, Guntersville, AL 35976 | 2006-07-07 |
| 1013531367 | Matt Donald Paulson | Radiologic Technologist | 3719 Dauphin St, Mobile, AL 36608-1753 | 2020-06-02 |
| 1194347450 | Nathan Perry | Radiologic Technologist | 1802 6th Ave S, Birmingham, AL 35233-1932 | 2020-05-09 |
| 1558627414 | Collin Conroy Bailey | Radiologic Technologist | 215 Perry Hill Rd, Department of Veterans Affairs Central Alabama, Montgomery, AL 36109 | 2012-04-05 |
| 1063585727 | Amanda L Burke | Radiologic Technologist | 1201 13th Ave Se, Decatur, AL 35601-4300 | 2006-11-17 |
| 1053480178 | Randal Craig Humphrey | Radiologic Technologist | 1201 13th Ave Se, Decatur, AL 35601-4300 | 2006-11-06 |
| 1588753297 | High Tech Imaging Center Inc | Radiologic Technologist | 1510 Forest Ave, Suite B, Montgomery, AL 36106-1517 | 2006-10-12 |
| Find all providers with the same taxonomy | ||||
| City | FORT RUCKER |
| Zip Code | 36362 |
Please comment or provide details below to improve the information on BRANDON CHEADLE.
| 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.