DR. ROCKY P.J. JEDICK (NPI# 1689802803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689802803 |
| Entity Type | Individual |
| Full Name | DR. ROCKY P.J. JEDICK |
| Credential | M.D. |
| Practice Address |
2206 Halsey Cir Davis CA 95618 |
| Mailing Address |
2206 Halsey Cir Davis CA 95618-6121 |
| Practice Telephone | 6148055127 |
| Mailing Telephone | 6148055127 |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2018-07-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 9550294-1205 | UT | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
2206 HALSEY CIR |
| City | DAVIS |
| State | CA |
| Zip Code | 95618 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568013332 | Maria Pilar Alonso Nunez | Social Worker | 2707 Henri Ct, Davis, CA 95618 | 2019-09-24 |
| 1437616349 | Dagon Jones Dds Inc. | Dentist | 2800 5th Street, Suite 100, Davis, CA 95618 | 2019-02-27 |
| 1265938484 | Martel Elizabeth Costa | Nurse Practitioner | 1909 Galileo Ct Ste A, Davis, CA 95618 | 2018-04-05 |
| 1952785644 | Avineet Boparai | Dentist | 4515 Fermi Pl Ste 106, Davis, CA 95618 | 2015-07-13 |
| 1063841096 | Sergio Vicuna Dental Corporation | Dentist | 4515 Fermi Place Suite 106, Davis, CA 95618 | 2013-11-12 |
| 1700103314 | Daren Allen Casagrande | Counselor | 315 Mace Blvd, Davis, CA 95618 | 2010-04-23 |
| 1356463004 | Vincent & Associates | Speech-Language Pathologist | 3560 J Street, Suite 1, Sacramento, CA 95618 | 2007-04-04 |
| 1316075138 | New Life Clinic | Acupuncturist | 1736 Picasso Ave., Suite B, Davis, CA 95618 | 2007-03-01 |
| 1558419622 | Baoping Li | Acupuncturist | 1736 Picasso Ave, Suite B, Davis, CA 95618 | 2007-01-08 |
| 1275691255 | Clark J Gregor | Dentist | 1756 Picasso Ave, Suite C, Davis, CA 95618 | 2006-12-04 |
| Find all providers in zip 95618 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932514973 | Kiah Connolly | Emergency Medicine | 3700 Arroyo Ave, Davis, CA 95618-7105 | 2014-06-29 |
| 1821185802 | Richard Ruel Blohm | Emergency Medicine | 39339 Spyglass Pl, Davis, CA 95616-7009 | 2006-10-09 |
| 1912015462 | Mark L. Palmeri | Emergency Medicine | 2000 Sutter Place, Davis, CA 95616-6201 | 2006-08-25 |
| 1316970338 | Michael Palchak | Emergency Medicine | 25133 County Road 96, Davis, CA 95616-9476 | 2006-07-10 |
| 1326346438 | Cep America - California | Emergency Medicine | 2000 Sutter Pl, Davis, CA 95616-6201 | 2011-03-14 |
| 1063504413 | Sutter Emergency Medical Associates | Emergency Medicine | 2000 Sutter Place, Davis, CA 95616-6201 | 2006-09-29 |
| 1841381548 | Gary A Roberts | Emergency Medicine | 2020 Sutter Pl, #101, Davis, CA 95616-6201 | 2006-09-27 |
| 1710095716 | Deven Babubhai Merchant | Emergency Medicine | 2000 Sutter Place, Davis, CA 95616 | 2006-08-29 |
| 1124136650 | Ryan N. Gorton | Emergency Medicine | 2000 Sutter Place, Davis, CA 95616-6201 | 2006-08-25 |
| 1871601310 | Robert L. Rosenthal | Emergency Medicine | 2000 Sutter Place, Davis, CA 95616-6201 | 2006-08-25 |
| Find all providers in DAVIS | ||||
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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.