MR. SEAN THOMAS SENGIAWASA MEADORS (NPI# 1659554400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659554400 |
| Entity Type | Individual |
| Full Name | MR. SEAN THOMAS SENGIAWASA MEADORS |
| Credential | SSIDC |
| Practice Address |
881 Uss James Madison Rd Kings Bay GA 31547-2531 |
| Mailing Address |
Unit 100241 Box 400 Fpo AA 34091-4104 |
| Practice Telephone | 9125736390 |
| Mailing Telephone | 9126748640 |
| Enumeration Date | 2007-12-14 |
| Last Update Date | 2018-04-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| Street Address |
881 USS JAMES MADISON RD |
| City | KINGS BAY |
| State | GA |
| Zip Code | 31547-2531 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528067337 | Andrea M Thaxton | Pediatrics | 881 Uss James Madison Rd, Kings Bay, GA 31547-2531 | 2005-07-14 |
| 1538644612 | Jamie Lynn Hughes | Dental Hygienist | 881 Uss James Madison Rd, Kings Bay, GA 31547-2531 | 2018-09-25 |
| 1114432085 | Branch Medical Clinic Kings Bay | Clinic/Center | 881 Uss James Madison Rd, Kings Bay, GA 31547-2531 | 2017-12-13 |
| 1811345002 | Karl Yves Grand Pierre | Physician Assistant | 881 Uss James Madison Rd, Kings Bay, GA 31547-2531 | 2016-05-27 |
| 1770994253 | Patrick Donnelly | Physician Assistant | 881 Uss James Madison Rd, Naval Branch Health Clinic Kings Bay, Kings Bay, GA 31547-2531 | 2014-05-18 |
| 1063839546 | Melissa Johnson | Registered Nurse | 881 Uss James Madison Rd, Kings Bay, GA 31547-2531 | 2014-03-24 |
| 1588955090 | Hillary Constance Smith | Dental Hygienist | 881 Uss James Madison Rd, Kings Bay, GA 31547-2531 | 2011-05-02 |
| 1922307024 | Kelly Renea Buchanan | Pharmacy Technician | 881 Uss James Madison Rd, Naval Submarine Base, Kings Bay, GA 31547-2531 | 2011-03-15 |
| 1851546535 | Leah Moss | Physician Assistant | 881 Uss James Madison Rd, Kings Bay, GA 31547-2531 | 2008-11-24 |
| 1942486139 | Roy Edmond Holder | Military Health Care Provider | 881 Uss James Madison Rd, Kings Bay, GA 31547-2531 | 2008-01-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922316785 | D'metric Maudell Moss | Nurse's Aide | 881 Uss James Madison Raod, Naval Submarine Base, Kings Bay, GA 31547 | 2010-09-15 |
| 1023291788 | Jay D Carson | Military Health Care Provider | 1050 Uss Gerogia Ave, Kings Bay, GA 31547 | 2007-12-17 |
| 1568651321 | Westley Michael Durnell | Military Health Care Provider | 580 Uss Mariano G. Vallejo Ave, Nssc Medical, Kings Bay, GA 31547 | 2007-10-17 |
| 1013127497 | Cory Dean Sant | Military Health Care Provider | Uss Rhode Island Ssbn 740 (blue), 1059 Uss Georgia Ave, Kings Bay, GA 31547 | 2007-05-23 |
| 1982760492 | Rufus Benjamin Phillips | Pharmacist | Kingsbay Naval Base, Pharmacy, Kingsbay, GA 31547 | 2006-12-29 |
| 1083626949 | Michael Dennis Lappi | Preventive Medicine | Naval Branch Health Clinic Kings Bay, Kings Bay, GA 31547 | 2006-08-12 |
| 1578592838 | Eric Windsor Larson Sr. | Military Health Care Provider | 580 Uss Mariano G Vallejo Ave, Nssc Medical Kings Bay, Kings Bay, GA 31547 | 2006-06-30 |
| 1104894294 | Cary Grinold | Nurse Practitioner | 881 Uss James Madison Road, Naval Ambulatory Care Center, Kings Bay, GA 31547 | 2006-03-14 |
| 1144429507 | Tony Wayne Lyle | Military Health Care Provider | 1061 Uss Tennessee Ave, Kings Bay, GA 31547 | 2007-07-16 |
| 1962634907 | Shanell Feldergoodman | Pharmacy Technician | 871 Uss James Madison, Saint Marys, GA 31547-2531 | 2009-08-10 |
| Find all providers in zip 31547 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275717092 | Michael Arnez Leggett | Military Health Care Provider | 1063 Uss Georgia Ave, Commander Submarine Group Ten, Kings Bay, GA 31558-2626 | 2007-12-28 |
| 1023291788 | Jay D Carson | Military Health Care Provider | 1050 Uss Gerogia Ave, Kings Bay, GA 31547 | 2007-12-17 |
| 1568651321 | Westley Michael Durnell | Military Health Care Provider | 580 Uss Mariano G. Vallejo Ave, Nssc Medical, Kings Bay, GA 31547 | 2007-10-17 |
| 1013127497 | Cory Dean Sant | Military Health Care Provider | Uss Rhode Island Ssbn 740 (blue), 1059 Uss Georgia Ave, Kings Bay, GA 31547 | 2007-05-23 |
| 1578592838 | Eric Windsor Larson Sr. | Military Health Care Provider | 580 Uss Mariano G Vallejo Ave, Nssc Medical Kings Bay, Kings Bay, GA 31547 | 2006-06-30 |
| 1356303655 | Julio Esquilin | Military Health Care Provider | 580 Uss Mariano G. Vallejo Avenue, Kings Bay, GA 31547-2626 | 2006-04-04 |
| 1033188925 | William S Legge | Military Health Care Provider | 1061 Uss Tennessee Ave, Kings Bay, GA 31547-2601 | 2006-03-14 |
| 1588187314 | Andrew Thomas Wemlinger | Military Health Care Provider | 1061 Uss Tennessee Ave, Kings Bay, GA 31547-2601 | 2017-07-24 |
| 1942486139 | Roy Edmond Holder | Military Health Care Provider | 881 Uss James Madison Rd, Kings Bay, GA 31547-2531 | 2008-01-17 |
| 1952587222 | Dmaurier Barnhart | Military Health Care Provider | 881 Uss James Madison Rd, Kings Bay, GA 31547-2531 | 2008-01-16 |
| Find all providers in KINGS BAY | ||||
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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.