EDWARD MANNING SPROWL III (NPI# 1588696520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588696520 |
| Entity Type | Individual |
| Full Name | EDWARD MANNING SPROWL III |
| Credential | PAC |
| Practice Address |
318 Abalone Loop Mescalero NM 88340 |
| Practice Telephone | 5754644441 |
| Mailing Telephone | 5754644441 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2011-02-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1016599 | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
MA001481L | PA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 38553562 | 05 | |
| AZ | 846537 | 05 |
| Street Address |
318 ABALONE LOOP |
| City | MESCALERO |
| State | NM |
| Zip Code | 88340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912957994 | Carmen Delia Cosme | Pediatrics | 318 Abalone Loop, Mescalero, NM 88340 | 2006-05-11 |
| 1326671751 | Matthew Ward | Pharmacist | 318 Abalone Loop, Mescalero, NM 88340 | 2020-02-13 |
| 1639643232 | Jiali He | Pharmacist | 318 Abalone Loop, Mescalero, NM 88340 | 2019-01-16 |
| 1265839633 | Luna Amelingmeier | General Practice | 318 Abalone Loop, Mescalero Hospital, Mescalero, NM 88340 | 2014-12-01 |
| 1649593443 | Mescalero Indian Hospital | Clinic/Center | 318 Abalone Loop, Mescalero, NM 88340 | 2010-03-08 |
| 1356663298 | Mescalero Indian Hospital | Nursing Facility/Intermediate Care Facility | 318 Abalone Loop, Mescalero, NM 88340-0318 | 2010-02-19 |
| 1295955490 | Barbara Bartram | Technician, Pathology | 318 Abalone Loop, Mescalero, NM 88340 | 2007-04-27 |
| 1104046309 | Ida L Saenz | Technician, Pathology | 318 Abalone Loop, Mescalero, NM 88340 | 2007-04-27 |
| 1609935931 | Suzanna Duran | Spec/Tech, Pathology | 318 Abalone Loop, Mescalero, NM 88340 | 2006-12-06 |
| 1881752970 | Linda M Miles | General Practice | 318 Abalone Loop, Mescalero, NM 88340-0210 | 2006-12-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346748282 | Mescalero Apache Tribe | Community/Behavioral Health | 311 War Bonnet Drive, Mescalero, NM 88340 | 2018-01-25 |
| 1487030755 | Marjorie Hogue | Pharmacist | 308 Abalone Loop, Mescalero, NM 88340 | 2015-08-10 |
| 1043641558 | Mescalero Apache Tribe | Ambulance | 25220 Highway 70, Mescalero, NM 88340 | 2013-12-09 |
| 1255681987 | Reginelle Tortilla | Case Manager/Care Coordinator | 249 Mountain Drive, Mescalero, NM 88340 | 2012-09-10 |
| 1689967051 | Yolanda Shemika Jenkins | Registered Nurse | 318 Abaloone Loop, Mescalero, NM 88340 | 2011-05-18 |
| 1972811487 | Pamela Rose Evans | Case Manager/Care Coordinator | 249 White Mtn. Dr., Mescalero, NM 88340 | 2010-09-17 |
| 1306162821 | David E Hernandez | Counselor | 148 Cottonwood Dr., Mescalero, NM 88340 | 2010-04-08 |
| 1235454018 | Steve A Loepz | Counselor | 148 Cottonwood Drive, Mescalero, NM 88340 | 2010-04-05 |
| 1457584666 | Valerie Vanaya Comanche | Case Manager/Care Coordinator | 249 White Mountain Dr., Mescalero, NM 88340 | 2009-09-03 |
| 1093948291 | Alicia Renee Chico | Case Manager/Care Coordinator | 249 White Mountain Drive, Mescalero, NM 88340 | 2009-09-03 |
| Find all providers in zip 88340 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902405442 | Lauren Elise Pincomb Apodaca | Physician Assistant | 2415 Janet Ann Ln, Las Cruces, NM 88007-5119 | 2020-10-24 |
| 1609474550 | Mara Swartzentruber | Physician Assistant | 3310 Linda Vista Ave Se, Albuquerque, NM 87106-1514 | 2020-10-13 |
| 1336757301 | Dailey Doss | Physician Assistant | Raymond G. Murphy Va Medical Center, 1501 San Pedro Se, Albuquerque, NM 87108 | 2020-07-16 |
| 1487287413 | Thomas Clise | Physician Assistant | 629 San Pablo St Ne, Albuquerque, NM 87108-2137 | 2020-02-18 |
| 1306478870 | Holly Howe | Physician Assistant | 2300 Grande Blvd Se # 4045, Rio Rancho, NM 87124-1755 | 2020-02-12 |
| 1427680750 | Mckenzi Hoffman | Physician Assistant | 465 Saint Michaels Dr Bldg Suite107, Santa Fe, NM 87505-7670 | 2020-02-05 |
| 1225678543 | Charla Marie Dunn | Physician Assistant | 701 Arizona St Ste A, Clovis, NM 88101-2110 | 2020-01-14 |
| 1912547324 | Kathleen Joyce L'heureux | Physician Assistant | 8124 Ventana Cielo Ave Nw, Albuquerque, NM 87114-5988 | 2020-01-14 |
| 1033752357 | Daniel Ray Spohn | Physician Assistant | 1630 Rio Rancho Dr Se, Rio Rancho, NM 87124-1587 | 2019-10-18 |
| 1528615101 | Michael La | Physician Assistant | 1202 Main St Ne Ste A, Los Lunas, NM 87031-7421 | 2019-08-20 |
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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.