MR. JOHN DUDLEY HARRIS JR. (NPI# 1467674150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467674150 |
| Entity Type | Individual |
| Full Name | MR. JOHN DUDLEY HARRIS JR. |
| Credential | IDCDMT |
| Practice Address |
33000 Nixie Way Bldg 50 San Diego CA 92147-5101 |
| Mailing Address |
6541 Hillgrove Dr San Diego CA 92120-4827 |
| Practice Telephone | 6195246668 |
| Practice Fax Number | 6195246670 |
| Mailing Telephone | 6195246668 |
| Mailing Fax Number | 6195246670 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1003X |
Military Health Care Provider Specialization: Independent Duty Medical Technicians |
Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912420845 | John Alton Harris IIi | Anesthesiology | 3106 Old Pond Rd, Missoula, MT 59802-3255 | 2017-07-23 |
| 1922521178 | John Mark Harris | Dentist | 1916 Hayes St, Nashville, TN 37203-2317 | 2017-07-19 |
| 1952710345 | John Harris I | Counselor | 4016 Gateway Dr, #120, Colleyville, TX 76034-5957 | 2014-08-11 |
| 1720326770 | John Eric Harris | Pharmacist | 308 Wormley Creek Dr, Yorktown, VA 23692-4213 | 2013-01-25 |
| 1699946996 | John Joel Harris Jr. | Anesthesiology | 587 Kelly Rd, Bladenboro, NC 28320-8969 | 2008-03-14 |
| 1861676215 | John Malcolm Harris Jr. | Internal Medicine | 5944 E Miramar Dr, Tucson, AZ 85715-3002 | 2007-12-20 |
| 1215139134 | John William Harris | Counselor | 244 Barclay Square Dr, Rochester, NY 14618-3137 | 2007-06-04 |
| 1407067754 | John Mark Harris | Counselor | 645 S 78th St, Omaha, NE 68114-5403 | 2007-05-25 |
| 1831307693 | John Olen Harris Jr. | Chiropractor | 2642 E Thomas Rd, Phoenix, AZ 85016-8243 | 2007-05-17 |
| 1093928277 | John Bruce Harris | Neurological Surgery | 2968 Colton Rd, Box 1615, Pebble Beach, CA 93953-2943 | 2007-05-07 |
| Street Address |
33000 NIXIE WAY BLDG 50 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92147-5101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811144546 | Nelson Jose Mejia | Military Health Care Provider | 33000 Nixie Way, Bldg.#50, Ste.#245, San Diego, CA 92147-5101 | 2008-08-25 |
| 1679848626 | Jose Alberto Rodriguez | Military Health Care Provider | 33000 Nixie Way, Bldg 50 Suite 245, San Diego, CA 92147-5109 | 2012-03-08 |
| 1871563387 | Rebecca Marie Ortenzio | Dentist | 32389 Echo Ln, Building 10, San Diego, CA 92147-5196 | 2006-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538760210 | Vanessa Nunez | Nursing Home Administrator | 1697 Donax Ave, San Diego, CA 92154-1004 | 2020-11-08 |
| 1295336956 | Ryan Russo | Clinical Nurse Specialist | 2376 Soto St, San Diego, CA 92107-1410 | 2020-11-07 |
| 1689275331 | Brenda L Curtis | Marriage & Family Therapist | 9191 Towne Centre Dr Ste 103, San Diego, CA 92122-1227 | 2020-11-07 |
| 1114528940 | Kaiser Foundation Health Plan Inc | Pharmacy | 4647 Zion Ave Fl4, Rm 4825, San Diego, CA 92120-2507 | 2020-11-06 |
| 1952902801 | Keri Castaneda | Behavior Technician | 025 Camino Del Rio South Suite 101, San Diego, CA 92108 | 2020-11-06 |
| 1396346359 | Christina L Thomas | Counselor | 4611 Alamo Dr, San Diego, CA 92115-5907 | 2020-11-05 |
| 1316548456 | Paulo Conceicao | Massage Therapist | 6559 Comly St, San Diego, CA 92111-5401 | 2020-11-05 |
| 1346841541 | Guadalupe Ibarra Sanders | Registered Nurse | 9022 Flanders Dr, San Diego, CA 92126-2826 | 2020-11-04 |
| 1720689987 | Capsule San Diego LLC | Pharmacy | 1450 Columbia St Ste B, San Diego, CA 92101-3487 | 2020-11-04 |
| 1265033583 | Mission Bay Hospice, Inc. | Hospice Care, Community Based | 10251 Vista Sorrento Pkwy Ste 280b, San Diego, CA 92121-3774 | 2020-11-03 |
| Find all providers in SAN DIEGO | ||||
| Taxonomy Code | 1710I1003X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Medical Technicians |
| An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians. |
| Notes: Source: Air Force Surgeon General Office [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093124398 | Benjamin Ryan Foy | Military Health Care Provider | 2784 Hornet Way, San Diego, CA 92106-6421 | 2014-08-12 |
| 1346552064 | Jeffrey Thomas Gilbert | Military Health Care Provider | 3841 Colina Dorado Dr, Apartment G108, San Diego, CA 92124 | 2010-07-10 |
| 1730157736 | Alfredo Alcalaesparza | Military Health Care Provider | 2211 Pacific Beach Dr, San Diego, CA 92109-5626 | 2006-03-08 |
| 1447606322 | Jeffrey Tyler Whitson | Military Health Care Provider | 34101 Farenholt Ave, Building 14, San Diego, CA 92134-7000 | 2016-05-10 |
| 1497927404 | Keren Mireya Lemas | Military Health Care Provider | 2450 Craven St, San Diego, CA 92136-5599 | 2008-03-31 |
| 1689873192 | Keith Robert Davis | Military Health Care Provider | 140 Sylvester Rd, Uss Topeka (ssn 754) Fpo Ap 96679-2410, San Diego, CA 92106-3521 | 2007-07-13 |
| 1740481571 | Cindy S Cruzan | Military Health Care Provider | 34101 Farenholt Ave, San Diego, CA 92134-7000 | 2007-05-30 |
| 1932169380 | Shirley Hovlid | Military Health Care Provider | 2650 Stockton Rd, San Diego, CA 92106-6000 | 2006-03-27 |
| 1851368229 | Carlos M. Coleman | Military Health Care Provider | 34101 Farenholt Ave, Nshs-sd Idc Dept, San Diego, CA 92134-7000 | 2006-03-03 |
| 1023085883 | Anthony Petrone Jr. | Military Health Care Provider | 140 Sylvester Rd, San Diego, CA 92106-3521 | 2006-03-01 |
| Find all providers in SAN DIEGO | ||||
Please comment or provide details below to improve the information on MR. JOHN DUDLEY HARRIS JR..
| 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.