SARA JEAN MATHEWS (NPI# 1669833018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1669833018 |
Entity Type | Individual |
Full Name | SARA JEAN MATHEWS |
Credential | MD |
Practice Address |
208 D L Ingram Ave W Cannon Afb NM 88103-5103 |
Practice Telephone | 5752652411 |
Practice Fax Number | 5757846329 |
Mailing Fax Number | 5757846329 |
Enumeration Date | 2016-03-14 |
Last Update Date | 2018-04-30 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care | ||
Y | 171000000X | Military Health Care Provider | 30237 | NE | Other Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225636137 | Sara Mathews | Pharmacist | 3900 Deerfield Dr, Janesville, WI 53546-4431 | 2020-10-13 |
1164930368 | Sara Mathews | Dietitian, Registered | 300 1st Capitol Dr, Saint Charles, MO 63301-2844 | 2018-01-22 |
Street Address |
208 D L INGRAM AVE W |
City | CANNON AFB |
State | NM |
Zip Code | 88103-5103 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427572205 | Mariia Lavnikevich | Dentist | 208 D L Ingram Ave W, Cannon Afb, NM 88103-5103 | 2017-08-02 |
1740716513 | Drew Robert Oen | Physical Therapist | 208 D L Ingram Ave W, Cannon Afb, NM 88103-5014 | 2017-05-11 |
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 | 171000000X |
Grouping | Other Service Providers |
Classification | Military Health Care Provider |
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
Notes: [7/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841803244 | Alyssa Marie Ortega | Military Health Care Provider | 4136 Rio Grande Blvd Nw, Albuquerque, NM 87107-3133 | 2020-08-25 |
1265748073 | Roscoe C Young Jr. | Military Health Care Provider | 505 Central Ave Nw Ste A, Albuquerque, NM 87102-3107 | 2010-08-31 |
1164581021 | Ann Marie Musto | Military Health Care Provider | 13 San Miguel Rd, Edgewood, NM 87015-7919 | 2006-12-07 |
1114526522 | Christopher Maestas | Military Health Care Provider | 2325 Cerrillos Rd, Santa Fe, NM 87505-3373 | 2020-10-19 |
1619430907 | Katelyn Jeanne Wilson | Military Health Care Provider | 1501 San Pedro Dr Se, Albuquerque, NM 87108-5153 | 2019-04-12 |
1518911254 | Richard Andrew Rock | Military Health Care Provider | 1501 San Pedro Dr Se, Albuquerque, NM 87108-5153 | 2006-05-19 |
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.