MR. RANDALL LEROY STEVENS (NPI# 1629044540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629044540 |
| Entity Type | Individual |
| Full Name | MR. RANDALL LEROY STEVENS |
| Credential | PA-C |
| Practice Address |
307 Boatner Rd Eglin Afb FL 32542-1391 |
| Practice Telephone | 8508838448 |
| Mailing Telephone | 8508838600 |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2007-10-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063587749 | Randall M Stevens | Internal Medicine | 125 Paterson St, Clinical Academic Building - Suite 5200a, New Brunswick, NJ 08901-1962 | 2006-11-21 |
| 1225029481 | Randall L Stevens | Family Medicine | 1513 N 6th 1/2 St, Terre Haute, IN 47807-1039 | 2005-11-04 |
| Street Address |
307 BOATNER RD |
| City | EGLIN AFB |
| State | FL |
| Zip Code | 32542-1391 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083618987 | Clarence E Pearson | Internal Medicine | 307 Boatner Rd, Suite 114, Eglin Afb, FL 32542-1302 | 2005-06-08 |
| 1821600024 | David George Morrison Jr. | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2020-08-19 |
| 1679185250 | Peter Andrew Watters | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2020-08-17 |
| 1558981365 | Kassandra Martinez-campos | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2020-04-22 |
| 1023638830 | Chanute Lockhart | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2020-04-22 |
| 1801434964 | Bryan Meek | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2019-12-19 |
| 1710525936 | Kaitlin Dickson | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2019-12-18 |
| 1376186213 | Kayle Elizabeth Southerland | Military Health Care Provider | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2019-10-23 |
| 1902452063 | Justin Michael Rhoads | Pharmacist | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2019-08-14 |
| 1295389609 | Joseph Clarence Smith Jr. | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542 | 2019-07-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417440306 | Colt Sicher | Student in an Organized Health Care Education/Training Program | 96th Dental Squadron (afmc), Eglin Afb, Fl 32542, Apo, AA 32542 | 2018-06-14 |
| 1841679529 | Matthew Scurria | Dentist | 340 Boatner Rd. Bldg 2751, 96 Dental Squadron/sgdr, Eglin Afb, FL 32542 | 2015-05-27 |
| 1134518798 | 96th Medical Support Squadron | Military/U.S. Coast Guard Pharmacy | 3120 A. Talon Way, Eglin Afb Fld #3, FL 32542 | 2015-01-20 |
| 1598177123 | 96th Medical Support Squadron | Military/U.S. Coast Guard Pharmacy | 96 Medical Group Satellite Phcy Memorial Trail, Bldg. 1758, Eglin Afb, FL 32542 | 2014-06-02 |
| 1548602923 | Gerald Jordan Novack | Psychologist | 96mdos/sgow, 307 Boatner Rd, Fpo, AP 32542 | 2013-07-25 |
| 1699112821 | Taylor Anne Hahn | Obstetrics & Gynecology | 96th Medical Group, 307 Boatner Road, Eglin Air Force Base, FL 32542 | 2013-05-29 |
| 1730456948 | Nicholas Brandon Sager | Dentist | 340 Boatner Rd, Eglin Afb, Apo, AA 32542 | 2011-11-17 |
| 1134402662 | Jessamy Jae Thornton | Student in an Organized Health Care Education/Training Program | 340 Boatner Rd, Bldg 2751, Eglin Afb, FL 32542 | 2011-09-21 |
| 1346523974 | Mary Elizabeth Sorrentino | Dentist | 340 Boatner Road, Blgd. 2751, Eglin Afb, FL 32542 | 2011-09-20 |
| 1588945612 | Martin Army Community Hospital | Clinic/Center | 4327 North El Salvador Way, Eglin Afb, FL 32542 | 2011-09-02 |
| Find all providers in zip 32542 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619919123 | Desmond John Biava | Physician Assistant | 307 Boatner Rd Ste 1b045, Eglin Afb, FL 32542-1302 | 2006-06-11 |
| 1831500636 | Goldy Sharma | Physician Assistant | 307 Boatner Rd, 96 Mdg/sgop/family Health, Eglin Afb, FL 32542-1302 | 2014-05-14 |
| 1407129257 | Jamie Meyer | Physician Assistant | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2012-02-09 |
| 1437460425 | Iveth A. Galvez Guzman | Physician Assistant | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2010-06-24 |
| 1881929107 | Angelica Carmen Worsham | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542-1391 | 2009-10-05 |
| 1083855159 | Timothy R George | Physician Assistant | 307 Boatner Rd, Eglin Afb, FL 32542-1391 | 2009-03-18 |
| 1821139957 | Esther Christine Allen | Physician Assistant | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2007-02-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255931325 | Jonathan Thomas Nusbaum | Physician Assistant | 26160 Angelica Rd, Punta Gorda, FL 33955-1419 | 2020-10-28 |
| 1235738659 | Kevin Marcus Luks | Physician Assistant | 10701 Santa Fe Dr, Hollywood, FL 33026-4955 | 2020-10-19 |
| 1245839521 | Stephanie Clay | Physician Assistant | 3455 Rose Mallow Loop, Oviedo, FL 32766-6648 | 2020-10-19 |
| 1104423755 | Lou Joseph Schneggenburger | Physician Assistant | 10115 Forest Hill Blvd Ste 100, Wellington, FL 33414-6178 | 2020-10-07 |
| 1235744582 | Stephanie Graham | Physician Assistant | 1053 Bernice Rd, Rockledge, FL 32955-2201 | 2020-09-14 |
| 1790399483 | Shyla Imani Kissoon | Physician Assistant | 4830 Nw 7th St, Plantation, FL 33317-1410 | 2020-09-01 |
| 1770193500 | My Physician Online | Physician Assistant | 9540 Nw 23rd St, Coral Springs, FL 33065-4974 | 2020-08-06 |
| 1225647977 | Robert Drew Singleton | Physician Assistant | 17501 Biscayne Blvd Ste 460, Aventura, FL 33160-4806 | 2020-07-29 |
| 1750990974 | Andrea K Webber | Physician Assistant | 8119 Sw State Rd 200, Ocala, FL 34481-3448 | 2020-07-23 |
| 1851919526 | Kyra Panni | Physician Assistant | 3857 Hartwood Ln, Jacksonville, FL 32216-1486 | 2020-07-09 |
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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.