SAMUEL THOMAS GILLILAND (NPI# 1679540645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679540645 |
| Entity Type | Individual |
| Full Name | SAMUEL THOMAS GILLILAND |
| Credential | IDC |
| Practice Address |
Naval Hospital Jacksonville 2080 Child St Jacksonville FL 32214-5000 |
| Practice Telephone | 9045423500 |
| Mailing Telephone | 9045423500 |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2012-07-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| INDEPENDENT DUTY CORPSMAN | 1710I1002X | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760772206 | Samuel Dwight Gilliland | Anesthesiology | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2011-04-18 |
| Street Address |
NAVAL HOSPITAL JACKSONVILLE 2080 CHILD ST |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32214-5000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972590826 | Jennifer Lisa Vedral-baron | Nurse Practitioner | Naval Hospital Jacksonville, 2080 Child Street, Jacksonville, FL 32214-0001 | 2005-10-05 |
| 1386178101 | Tej Bhula Diah | Dentist | Naval Hospital Jacksonville, Jacksonville, FL 32214-0001 | 2017-04-18 |
| 1588032809 | Ralee Spooner | Dentist | Naval Hospital Jacksonville, 2080 Child St., Jacksonville, FL 32214-0001 | 2015-09-03 |
| 1114367562 | Lundon Shari Brown | Registered Nurse | Naval Hospital Jacksonville, Jacksonville, FL 32214-0001 | 2013-06-30 |
| 1700126026 | James Dominic Haddad | Internal Medicine | Naval Hospital Jacksonville, 2080 Child Street, Jacksonville, FL 32214-0001 | 2013-02-23 |
| 1932468055 | Joshua Tatum | Student in an Organized Health Care Education/Training Program | Naval Hospital Jacksonville, 2080 Child Street, Jacksonville, FL 32214-0001 | 2012-05-09 |
| 1790051118 | Robert Merle Obryan | Emergency Medicine | Naval Hospital Jacksonville, 2080 Child Street, Jacksonville, FL 32214-0001 | 2012-03-29 |
| 1265709869 | Christine Dahl Davies | Nurse Practitioner | Naval Hospital Jacksonville, 2080 Child Street, Jacksonville, FL 32214-0001 | 2011-11-27 |
| 1578707444 | Laurie Ann Hale | Nurse Practitioner | Naval Hospital Jacksonville, 2018 Child Street, Jacksonville, FL 32214-0001 | 2009-04-23 |
| 1073697025 | Kristian E Sanchack | Family Medicine | Naval Hospital Jacksonville, 2080 Childs St, Jacksonville, FL 32214-0001 | 2006-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699255653 | Natalia Rosa Terreros | Nurse Practitioner | 2080 Childs Street, Jacksonville, FL 32214 | 2018-08-20 |
| 1841586120 | Travis Christopher Allemang | Urology | 2080 Child St Dept 5000, Jacksonville, FL 32214 | 2011-06-24 |
| 1730169202 | Quinn Steven Bastian | Psychologist | 2080 Child Street, Mental Health Dept - Bldg 2034 / Nh Jax, Jacksonville, FL 32214 | 2006-01-19 |
| 1407342314 | Jeremiah D. Bond | Nurse Anesthetist, Certified Registered | 2080 Child St, Jacksonville, FL 32214 | 2018-07-03 |
| 1295228393 | Christopher John Gilbertson | Student in an Organized Health Care Education/Training Program | 2080 Child St, Jacksonville, FL 32214 | 2018-06-13 |
| 1043714405 | Adam Blake Hoynacki | Student in an Organized Health Care Education/Training Program | 2080 Child St, Jacksonville, FL 32214 | 2018-03-21 |
| 1154825461 | Andrew Charles Caudill | Military Health Care Provider | 2080 Child St, Jacksonville, FL 32214 | 2018-03-21 |
| 1114447950 | Brenna Michelle Smith | Pharmacist | 2080 Child St, Jacksonville, FL 32214 | 2017-06-22 |
| 1639558687 | Catherine Phuong-tu Perrault | Student in an Organized Health Care Education/Training Program | 2080 Child St, Jacksonville, FL 32214 | 2015-05-22 |
| 1184044950 | Jason Michael Pesqueira | Student in an Organized Health Care Education/Training Program | 2080 Child St, Family Medicine Clinic, Jacksonville, FL 32214 | 2014-04-21 |
| Find all providers in zip 32214 | ||||
| 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 |
|---|---|---|---|---|
| 1639793748 | Johnathon T Brewer | Military Health Care Provider | 100 White St, Jacksonville, NC 28540 | 2020-06-04 |
| 1740803725 | Alanna Gonzalez | Military Health Care Provider | 1453 Lindseys Crossing Dr, Jacksonville, FL 32218-8088 | 2020-05-25 |
| 1538793849 | Alberto Kris Cipollone | Military Health Care Provider | Bon Homme Richard Ave Bldg 2480, Jacksonville, FL 32246-0046 | 2020-02-25 |
| 1376175794 | James Ernest Claypool | Military Health Care Provider | 12411 Glenn Hollow Dr, Jacksonville, FL 32226-2349 | 2020-02-05 |
| 1316584543 | Christina Koch | Military Health Care Provider | 104 Eagle River Ct, Jacksonville, NC 28540-7745 | 2019-12-06 |
| 1174043244 | Jason Waters | Military Health Care Provider | White St, Bldg As-100, Jacksonville, NC 28540 | 2017-06-21 |
| 1023546108 | Gregory Donald Willden | Military Health Care Provider | Bon Homme Richard St, Bldg 2480, Jacksonville, FL 32228 | 2017-06-01 |
| 1285179077 | Bill Lee Todd Davis | Military Health Care Provider | 1151 Murrill Hill Rd, Jacksonville, NC 28540-8662 | 2017-01-03 |
| 1235681545 | Huriel A Rivera Aponte | Military Health Care Provider | Naval Station Mayport, Surflant Medical Readiness Division Detachment Mayport, Jacksonville, FL 32228 | 2016-11-03 |
| 1659727444 | Michael Phoenix Mcfarland | Military Health Care Provider | 898 Enterprise St Unit A, Jacksonville, FL 32227-1202 | 2016-05-11 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32214 |
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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.