DR. JACKIE W WESTFALL (NPI# 1740248152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740248152 |
| Entity Type | Individual |
| Full Name | DR. JACKIE W WESTFALL |
| Credential | DO |
| Practice Address |
2370 E International Speedway Blvd Deland FL 32724-2744 |
| Practice Telephone | 3867361105 |
| Practice Fax Number | 3867341443 |
| Mailing Telephone | 3867361105 |
| Mailing Fax Number | 3867341443 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2014-10-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | OS5855 | FL | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | OS5855 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 054261000 | 05 | |
| FL | BCBS PROVIDER NUMBER | 80464 | 01 |
| Street Address |
2370 E INTERNATIONAL SPEEDWAY BLVD |
| City | DELAND |
| State | FL |
| Zip Code | 32724-2744 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518955889 | Stanley Francis Stockhammer Jr. | Family Medicine | 2370 E International Speedway Blvd, Deland, FL 32724-2744 | 2005-10-11 |
| 1093253890 | Med Equity Partners, LLC | Family Medicine | 2370 E International Speedway Blvd, Deland, FL 32724-2744 | 2017-02-01 |
| 1053784983 | Carmelia Maria Lee | Nurse Practitioner | 2370 E International Speedway Blvd, Deland, FL 32724 | 2015-10-30 |
| 1578551842 | Stanley F. Stockhammer, Jr. D.o., P.a. | Family Medicine | 2370 E International Speedway Blvd, Deland, FL 32724-2744 | 2005-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528549490 | Ultra Health Providers of Florida | Internal Medicine | 105 Asterbrooke Dr, Deland, FL 32724 | 2018-08-28 |
| 1811473275 | April Gustafson | Nurse Practitioner | 557 Adenmore Ter, Deland, FL 32724 | 2018-07-18 |
| 1245720820 | Total Renal Laboratories Inc | Clinical Medical Laboratory | 3000 Davita Way, Deland, FL 32724 | 2018-05-18 |
| 1790294742 | Deland Manor Assisted Living Corp | Assisted Living Facility | 245 S. Amelia Ave, Deland, FL 32724 | 2017-09-21 |
| 1639617954 | Starting Point Mental Health, LLC | Counselor | 620 East New York Ave Ste B, Deland, FL 32724 | 2017-02-07 |
| 1255877221 | Emily Eunice | Specialist/Technologist | 2589 W Lake Dr., Deland, FL 32724 | 2017-01-13 |
| 1073960357 | Robert Solomon Jr. | Family Medicine | 1431 Orange Camp Rd Ste 118119, Deland, FL 32724 | 2016-05-17 |
| 1730535568 | Harold Alexander | Hearing Instrument Specialist | 124 S. Amelia Ave, Unit #b, Deland, FL 32724 | 2016-05-11 |
| 1720406747 | Angel Care Homes LLC | Assisted Living Facility | 1349 E. Wisconsin Avenue, Deland, FL 32724 | 2014-04-07 |
| 1508298860 | Lindenlea Assisted Living Inc. | Assisted Living Facility | 1180 Jackson Ranch Rd, Deland, FL 32724 | 2013-08-08 |
| Find all providers in zip 32724 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902448715 | Volusia Medical Center LLC | Family Medicine | 850 N. Stone Street, Deland, FL 32720 | 2019-10-14 |
| 1295275378 | Deland Medical Center LLC | Family Medicine | 320 S Spring Garden Ave, Ste D, Deland, FL 32720-5087 | 2017-03-08 |
| 1073960357 | Robert Solomon Jr. | Family Medicine | 1431 Orange Camp Rd Ste 118119, Deland, FL 32724 | 2016-05-17 |
| 1225483803 | Wesley Kramer | Family Medicine | 2293 S Woodland Blvd, Deland, FL 32720-8633 | 2016-05-02 |
| 1972948826 | Carehere LLC | Family Medicine | 151 Victoria Commons Blvd Ste 103, Deland, FL 32724-7722 | 2013-05-06 |
| 1639443260 | Angella M. Glidden-wood | Family Medicine | 909 N Stone St, Deland, FL 32720-2521 | 2012-02-29 |
| 1932376282 | Fabiola Dutes Fairgrieve | Family Medicine | 2836 Shenandoah Rd, Deland, FL 32720-1426 | 2008-05-14 |
| 1407026016 | Northeast Florida Health Services Inc | Family Medicine | 844 W Plymouth Ave, Deland, FL 32720-3284 | 2008-03-11 |
| 1821268079 | Selma C Delima Md Pa | Family Medicine | 923 N Spring Garden Ave, Deland, FL 32720-2560 | 2008-03-04 |
| 1225217474 | Brent D. Schlapper | Family Medicine | 1015 N Stone St, Suite A, Deland, FL 32720-0802 | 2007-10-24 |
| Find all providers in DELAND | ||||
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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.