MR. CHASE CHESTERMAN (NPI# 1649814120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649814120 |
| Entity Type | Individual |
| Full Name | MR. CHASE CHESTERMAN |
| Credential | RD |
| Practice Address |
27th Special Operations Medical Group 224 W Dl Ingram Ave Cannon Afb NM 88103-5103 |
| Practice Telephone | 5759043917 |
| Practice Fax Number | 5757846028 |
| Mailing Telephone | 5759043917 |
| Mailing Fax Number | 5757846028 |
| Enumeration Date | 2019-10-29 |
| Last Update Date | 2019-10-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers |
| Street Address |
27TH SPECIAL OPERATIONS MEDICAL GROUP 224 W DL INGRAM AVE |
| City | CANNON AFB |
| State | NM |
| Zip Code | 88103-5103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972833523 | Deborah J Angeles | Nurse Practitioner | 27th Special Operations Medical Group, 224 W Dl Ingram Ave, Cannon Afb, NM 88103-5103 | 2010-01-04 |
| 1134613342 | Nicholas F Polk | Social Worker | 27th Special Operations Medical Group, 224 W D.l. Ingram Ave, Cannon Afb, NM 88103-5103 | 2018-06-20 |
| 1144725755 | Kent Andrew Boucher | General Practice | 27th Special Operations Medical Group, 224 W Dl Ingram Ave, Cannon Afb, NM 88103-5103 | 2018-03-26 |
| 1184137218 | Racheal L Rivera | Nurse Practitioner | 27th Special Operations Medical Group, 27 Somdg/sghc, Cannon Afb, NM 88103-5103 | 2017-11-11 |
| 1821510033 | Wallace D Cleveland Jr. | Physician Assistant | 27th Special Operations Medical Group, 224 W D.l. Ingram Ave, Cannon Afb, NM 88103-5103 | 2017-07-10 |
| 1497104194 | Anne M Murphy | Pediatrics | 27th Special Operations Medical Group, 224 W Dl Ingram Ave, Cannon Afb, NM 88103-5103 | 2016-06-03 |
| 1265848576 | John M Richardson | Family Medicine | 27th Special Operations Medical Group, 244 W D.l. Ingram Ave, Cannon Afb, NM 88101-5103 | 2014-07-08 |
| 1710287362 | Julie A Thomas | Nurse Practitioner | 27th Special Operations Medical Group, 224 W Dl Ingram Ave, Cannon Afb, NM 88103-5103 | 2010-10-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346747151 | Isabella Wolak | Pharmacist | 224 D L Ingram Blvd, Cannon Afb, NM 88103 | 2018-04-09 |
| 1225480544 | Stacey Tatro | Dentist | 224 West D.l. Ingram Ave., Bldg 1408, Cannon Afb, NM 88103 | 2016-07-11 |
| 1871965673 | Chad Bryan Carter | Dentist | 224 W Dl Ingram Ave, Sgpd/dental Clinic, Cannon Air Force Base, NM 88103 | 2015-10-20 |
| 1740660836 | Terah Clifford | Dental Hygienist | 224 W Dl Ingram Blvd, Bldg 1408 Dental Clinic, Cannon Afb, NM 88103 | 2015-06-03 |
| 1528452208 | Taylor Bottari | Physician Assistant | 208 W Dl Ingram, Cannon Afb, NM 88103 | 2015-03-20 |
| 1588071328 | Gretchen Evelynn Szymanski | Nurse Practitioner | Cannon Afb, 224 W D.l. Ingram Blvd, Cannon Afb, NM 88103 | 2014-07-14 |
| 1396155206 | Jennifer Brynn Bendokas | Physician Assistant | 224 West Dl Ingram Avenue, Cannon Afb, NM 88103 | 2014-04-30 |
| 1366889487 | Jeremy Michael Strohmayer | General Practice | 511 Chindt Blvd Building 300, 27soss/osm, Cannon Afb, NM 88103 | 2013-05-30 |
| 1356622401 | Matthew John Nielsen | Dentist | 224 W D.l. Ingram, Bld. 1408, Cannon Afb, NM 88103 | 2011-09-02 |
| 1689965485 | Bryan Wade Sixkiller | Optometrist | 27th Somdg, 208 W. Casa Blanca Ave., Apo, AA 88103 | 2011-04-27 |
| Find all providers in zip 88103 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396217170 | Nathanael Hand | Dietitian, Registered | 208 W Casablanca Ave, Cannon Afb, NM 88103-5009 | 2018-12-18 |
| 1073777058 | Lara Engler Fuson | Dietitian, Registered | 208 W Casablanca Ave, Building 444, Cannon Afb, NM 88103-5009 | 2008-07-18 |
| 1558386979 | Jeremiah Edwin Johnson | Dietitian, Registered | 208 W Casablanca Ave, 27 Somdg/sgpm, Cannon Afb, NM 88103-5009 | 2006-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972117661 | Jose Luis Guzman Jr. | Dietitian, Registered | 947 Cerrito Dr Apt A, Gallup, NM 87301-5421 | 2020-09-01 |
| 1184237075 | Kelly Ann Gardiner | Dietitian, Registered | 9123 Retablo Rd Nw, Albuquerque, NM 87120-7138 | 2020-08-28 |
| 1356954929 | Hannah Contrucci | Dietitian, Registered | 2920 Carlisle Blvd Ne Ste A1, Albuquerque, NM 87110-2867 | 2020-08-25 |
| 1083227656 | Advanced Nutrition Services, LLC | Dietitian, Registered | 2920 Carlisle Blvd Ne, Ste A1, Albuquerque, NM 87110-2867 | 2020-08-25 |
| 1366051997 | Uma Borkar | Dietitian, Registered | 4425 Ojo Caliente Cir, Las Cruces, NM 88011-4303 | 2020-07-29 |
| 1376152108 | Stephanie Faith Swarthout | Dietitian, Registered | 1401 10th St Ste E, Alamogordo, NM 88310-5012 | 2020-07-28 |
| 1912525445 | Sunrise Nutrition Services, LLC | Dietitian, Registered | 601 C Avenue, Zuni, NM 87327-8732 | 2020-07-10 |
| 1417575267 | Valerie Silver | Dietitian, Registered | 6225 Hannett Ave Ne, Albuquerque, NM 87110-5918 | 2020-07-08 |
| 1295350346 | Amanda Montano | Dietitian, Registered | 9928 Cielito Norte Way Ne, Albuquerque, NM 87122-3222 | 2020-06-15 |
| 1457974420 | Juliet Corley | Dietitian, Registered | 926 Madeira Dr Se, Albuquerque, NM 87108-3618 | 2020-05-25 |
| Find all providers with the same taxonomy | ||||
| City | CANNON AFB |
| Zip Code | 88103 |
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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.