DARRELL KEVIN TEGTMEYER (NPI# 1831186360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831186360 |
| Entity Type | Individual |
| Full Name | DARRELL KEVIN TEGTMEYER |
| Credential | MPAS, PA-C |
| Practice Address |
204 W Hill Blvd Charleston Afb SC 29404-4704 |
| Mailing Address |
1139 Whitetail Dr Fairborn OH 45324-9467 |
| Practice Telephone | 8439636989 |
| Mailing Telephone | 9378782555 |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2018-03-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
2822 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
204 W HILL BLVD |
| City | CHARLESTON AFB |
| State | SC |
| Zip Code | 29404-4704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164080768 | Eric Wayne Robertson | Registered Nurse | 204 W Hill Blvd, Charleston Afb, SC 29404-4704 | 2019-05-30 |
| 1467938290 | Nicholas Trudo | Physician Assistant | 204 W Hill Blvd, Charleston Afb, SC 29404-4704 | 2018-07-16 |
| 1235655754 | Jessica Reynolds | Pharmacist | 204 W Hill Blvd, Charleston Afb, SC 29404-4704 | 2017-08-16 |
| 1356871032 | Karina Cortes | Military Health Care Provider | 204 W Hill Blvd, Charleston Afb, SC 29404-4704 | 2017-06-15 |
| 1093250839 | Thi Nguyen | Pharmacist | 204 W Hill Blvd, 628th Medical Group, Charleston Afb, SC 29404-4704 | 2017-01-03 |
| 1952857393 | Krystal Hasselvander | Social Worker | 204 W Hill Blvd, Charleston Afb, SC 29404-4704 | 2016-08-26 |
| 1447650502 | Jeffrey Chase Yee | Dentist | 204 W Hill Blvd, Charleston Afb, SC 29404-4704 | 2014-08-26 |
| 1659770980 | Khiem Nguyen | Dentist | 204 W Hill Blvd, Charleston Afb, SC 29404-4704 | 2014-08-22 |
| 1063852978 | Chantell Renee Mckee | Family Medicine | 204 W Hill Blvd, Charleston Afb, SC 29404 | 2013-06-25 |
| 1114261526 | Brett Randall | Military Health Care Provider | 204 W Hill Blvd, Charleston Afb, SC 29404-4704 | 2012-11-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346751971 | James Tyrone Wilder | Social Worker | B, 1001 Michigan Ave, Joint Base, Charleston, SC 29404 | 2017-10-23 |
| 1033422902 | Michael Ryan Moore | Physical Therapist | 628th Medical Group, 204 West Hill Blvd, Charleston, SC 29404 | 2010-07-21 |
| 1720221013 | Cristy Jo Preslar | Military Health Care Provider | 364 Arthur Drive, Charleston Afb, SC 29404 | 2009-04-16 |
| 1336237627 | Douglas Vail Campbell | Psychologist | 437mdos/lssc - 204 West Hill Blvd, Charleston Afb, SC 29404 | 2006-10-11 |
| 1124019914 | Neal Robert Taylor | Family Medicine | 628 Medical Group 204 W. Hill Blvd, Jb Charleston, SC 29404 | 2005-11-02 |
| 1295092328 | Suzanne M O'shea | Registered Nurse | 204 W. Hill Blvd, Charleston, SC 29404-0000 | 2012-04-13 |
| 1306281373 | Michelle Karen Calandra | Registered Nurse | 1000 Michigan Ave, Charleston Afb, SC 29404-2020 | 2013-05-06 |
| 1336560440 | Merin Williams | Speech-Language Pathologist | 1000 Michigan Ave, Charleston Afb, SC 29404-2020 | 2013-12-17 |
| 1154884468 | Palmetto Pa Assist, LLC | Physician Assistant | 101 Lawson Dr # 103, Charleston, SC 29404-2121 | 2019-04-12 |
| 1750811089 | Radiant Neuromonitoring LLC | Psychiatry & Neurology | 101 Lawson Dr # 104, Charleston, SC 29404-2121 | 2017-06-19 |
| Find all providers in zip 29404 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639257025 | Samuel Holbrook Halverson | Physician Assistant | 204 W Hill Blvd, Charleston Afb, SC 29404-4704 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639712482 | Brianna Julia Starr | Physician Assistant | 1403 E Greenville St Ste B, Anderson, SC 29621-2285 | 2019-10-24 |
| 1255974655 | Kaitlyn T Brown | Physician Assistant | 808 Farrar Drive, Conway, SC 29526-8747 | 2019-10-18 |
| 1053960914 | Chad Waddell | Physician Assistant | 107 Walnut Ln, North Augusta, SC 29860-8629 | 2019-09-04 |
| 1508429317 | Charlotte H. Hanna | Physician Assistant | 800 E Cheves St Ste 380, Florence, SC 29506-2649 | 2019-04-17 |
| 1407342116 | Thrive Essential Wellness, Inc. | Physician Assistant | 1511 9th Ave Ste A, Conway, SC 29526-4126 | 2018-07-05 |
| 1700392495 | Stephanie Meyer | Physician Assistant | 5 Medical Park Road Palmetto Health, Columbia, SC 29203 | 2017-12-18 |
| 1073022612 | Gina Marie Sanitato | Physician Assistant | 1300 Hospital Dr Ste 300, Mt Pleasant, SC 29464-3217 | 2017-09-27 |
| 1659896264 | Morgan N Warthan | Physician Assistant | Gateway Family Medicine, 406 N Poinsett Hwy, Travelers Rest, SC 29690-1667 | 2017-08-04 |
| 1366994824 | Colonial Family Practice, LLC | Physician Assistant | 3750 Savannah Hwy Ste I, Johns Island, SC 29455-7909 | 2016-11-01 |
| 1457804080 | Mcleod Physician Associates II | Physician Assistant | 945 82nd Pkwy Ste 3, Myrtle Beach, SC 29572-4612 | 2016-08-01 |
| Find all providers with the same taxonomy | ||||
| City | CHARLESTON AFB |
| Zip Code | 29404 |
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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.