CARL MAYBERRY (NPI# 1508210287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508210287 |
| Entity Type | Individual |
| Full Name | CARL MAYBERRY |
| Credential | MBA,CRA,ARRT(R)(CT) |
| Practice Address |
Madigan Army Medical Ctr 9040 Jackson Ave Tacoma WA 98431-1100 |
| Mailing Address |
Madigan Army Medical Ctr 9040 Jackson Ave Attn:mchj-clq-c Tacoma WA 98431-1100 |
| Practice Telephone | 2539682147 |
| Practice Fax Number | 2539682024 |
| Mailing Telephone | 2539682147 |
| Mailing Fax Number | 2539682024 |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2016-04-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247100000X | Radiologic Technologist | 203671 | Technologists, Technicians & Other Technical Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538241567 | Carl C Mayberry | Physician Assistant | 4900 Fannin St, Houston, TX 77004-5706 | 2006-10-19 |
| Street Address |
MADIGAN ARMY MEDICAL CTR 9040 JACKSON AVE |
| City | TACOMA |
| State | WA |
| Zip Code | 98431-1100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033114954 | Larry E Witham | Physician Assistant | Madigan Army Medical Ctr, 9040a Reid Street, Tacoma, WA 98431-1100 | 2005-06-16 |
| 1417483512 | Carah Labrier | Emergency Medical Technician, Basic | Madigan Army Medical Ctr, 9040 Jackson Aveunue, Tacoma, WA 98431-0001 | 2017-05-10 |
| 1396270823 | Cherise Janen Hartman | Pharmacy Technician | Madigan Army Medical Ctr, 9040 Jackson Ave Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2017-04-21 |
| 1356876924 | Joseph Durso | Student in an Organized Health Care Education/Training Program | Madigan Army Medical Ctr, 9040 Jackson Avenue, Tacoma, WA 98431-0001 | 2017-04-20 |
| 1891228474 | Alfonso David Bernal-stevens | Emergency Medical Technician, Basic | Madigan Army Medical Ctr, 9040 Jackson Ave, Attn Mchj-clq-c, Tacoma, WA 98431-1100 | 2017-04-10 |
| 1730612573 | Tifani Mcgovern | Registered Nurse | Madigan Army Medical Ctr, 9040 Jackson Ave Attn: Mchj-clq-c, Tacoma, WA 98431-0001 | 2017-04-08 |
| 1770024184 | Susan Marie Beale | Licensed Practical Nurse | Madigan Army Medical Ctr, 9040 Jackson Ave, Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2017-03-17 |
| 1417498957 | Danielle Jones | Pharmacy Technician | Madigan Army Medical Ctr, 9040 Jackson Ave. Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2017-03-16 |
| 1962943514 | Edwin Pampo | Registered Nurse | Madigan Army Medical Ctr, 9040 Jackson Ave Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2017-03-15 |
| 1497296578 | Margie Ayala | Technician, Pathology | Madigan Army Medical Ctr, 9040 Jackson Ave Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2017-03-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497212260 | Catrina Renee Grugin | Registered Nurse | Madigan Army Medical Center, Attn Mchj-clq-c, 9040 Jackson Ave, Tacoma, WA 98431 | 2019-02-27 |
| 1801307681 | Bianca Gomez | Dental Assistant | Bldg 9900 Lincoln Street, Jblm, WA 98431 | 2017-10-19 |
| 1184133225 | Darren Paris | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave., Attn: Mchj-clq-c, Tacoma, WA 98431 | 2017-09-20 |
| 1922538206 | Sarah Frerichs | Dentist | Madigan Annex, Second Floor, Bldg. 9900, Apo, AA 98431 | 2017-06-19 |
| 1740736495 | Misty Hill | Dental Assistant | 9119 Mill Park Ave, Tacoma, WA 98431 | 2016-08-31 |
| 1336695535 | Jacqueline D Massouda | Dentist | Jblm Dentac, 9900 Lincoln Sreet, 2nd Floor, Apo, AA 98431 | 2016-08-28 |
| 1609239375 | Gregg V Palmer | Licensed Practical Nurse | 17th and C Street, Bldg 11582, Tacoma, WA 98431 | 2016-03-31 |
| 1114323904 | Deanna Sheets | Nurse Practitioner | 911 Mil Park Ave, Tacoma, WA 98431 | 2014-11-06 |
| 1679905434 | Austin William Schaar | Dentist | Building 9900, 2nd Floor, Tacoma, WA 98431 | 2013-08-05 |
| 1518209758 | Maurice Ibrahim Khayat | Internal Medicine | 9040 Jackson Ave Mche-qd (creds), Tacoma, WA 98431 | 2013-03-26 |
| Find all providers in zip 98431 | ||||
| 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 |
|---|---|---|---|---|
| 1417078338 | Dynamic Imaging Centers LLC | Radiologic Technologist | 5038 Tacoma Mall Blvd Ste C, Tacoma, WA 98409-7140 | 2007-04-02 |
| 1124661558 | Josiah Chupik | Radiologic Technologist | Madigan Army Medical Center, 9040 Jackson Ave, Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2019-10-17 |
| 1942764543 | Haley N Hill | Radiologic Technologist | 9040 Jackson Ave Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2019-01-28 |
| 1982145249 | Joseph Blake Bradley | Radiologic Technologist | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-1100 | 2017-03-19 |
| 1063953321 | Dong Hae Park | Radiologic Technologist | Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-1100 | 2017-03-19 |
| 1356660930 | Joseph Leonardo Marin | Radiologic Technologist | Fitzsimmons Dr Bldg 9040, Tacoma, WA 98431-0001 | 2010-05-22 |
| 1417924655 | Tacoma Orthopaedic Surgeons Inc | Radiologic Technologist | 2420 S Union, Ste 300, Tacoma, WA 98405-1387 | 2006-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076677 | Alexander Toro Rivas | Radiologic Technologist | 5914 158th Way Ne, Redmond, WA 98052-4812 | 2020-09-04 |
| 1043600836 | Bruce Roderick Nielson | Radiologic Technologist | 415 Ne 194th St, Unit 1, Ridgefield, WA 98642-9496 | 2015-01-30 |
| 1598160285 | Young Nam Yoo | Radiologic Technologist | 28705 34th Ave S, Apt K106, Auburn, WA 98001 | 2014-10-24 |
| 1902213861 | J Daniel Kelleher | Radiologic Technologist | 24 Roy St # 457, Seattle, WA 98109-4018 | 2014-07-11 |
| 1194137786 | Julia Ann Katzenmaier | Radiologic Technologist | 23415 27th Ave S, Des Moines, WA 98198-8743 | 2014-05-30 |
| 1093126567 | Gary Dale Kirschner | Radiologic Technologist | 24230 85th Ave Se, Woodinville, WA 98072-9525 | 2014-05-18 |
| 1417373549 | Jayme Ebner | Radiologic Technologist | 1517 N Lacey St, Spokane, WA 99207-5272 | 2014-03-13 |
| 1184949117 | Thomas Olof Malmevik | Radiologic Technologist | 3106 123rd St Se, Everett, WA 98208-6146 | 2010-04-01 |
| 1801118468 | Lynne Marie Bennett | Radiologic Technologist | 2325 Pleasanton Ct Se, Lacey, WA 98503-3410 | 2010-02-24 |
| 1790013233 | Arthur Alan Stevens | Radiologic Technologist | 12105 38th Ave Ne, Marysville, WA 98271-8412 | 2009-11-20 |
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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.