JAKE CHARLIE (NPI# 1851691638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851691638 |
| Entity Type | Individual |
| Full Name | JAKE CHARLIE |
| Practice Address |
167 N. Main Street Tuba City AZ 86045-0600 |
| Mailing Address |
Po Box 600 Tuba City AZ 86045-0600 |
| Practice Telephone | 9282832501 |
| Mailing Telephone | 9282832501 |
| Enumeration Date | 2010-10-27 |
| Last Update Date | 2010-10-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 172A00000X | Driver | CNA999953632 | AZ | Other Service Providers |
| Street Address |
167 N. MAIN STREET |
| City | TUBA CITY |
| State | AZ |
| Zip Code | 86045-0600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043379779 | David Erickson | Respiratory Therapist, Registered | 167 N. Main Street, Tuba City, AZ 86045-0600 | 2006-12-08 |
| 1437630860 | Sophenia Grover | Pharmacist | 167 N. Main Street, Tuba City, AZ 86045 | 2018-08-23 |
| 1548768922 | Alexandria Edwards | Pharmacist | 167 N. Main Street, Tuba City, AZ 86045 | 2018-01-31 |
| 1760939250 | Kathleen Mcdonald | Physician Assistant | 167 N. Main Street, Tuba City, AZ 86045 | 2016-09-01 |
| 1033580717 | Alvin Palmer | Physician Assistant | 167 N. Main Street, Tuba City, AZ 86045 | 2015-10-07 |
| 1003295866 | Marizela Samaniego | Respiratory Therapist, Registered | 167 N. Main Street, Tuba City, AZ 86045-3086 | 2015-05-27 |
| 1114306974 | Katherine J Bannon | Physical Therapist | 167 N. Main Street, Tuba City, AZ 86045-0600 | 2015-05-27 |
| 1194089151 | Teresa Diane Kilborn | Dentist | 167 N. Main Street, Tuba City, AZ 86045 | 2012-06-25 |
| 1558647172 | Shanice Lynn Dempsey | Nurse's Aide | 167 N. Main Street, Tuba City, AZ 86045 | 2011-10-27 |
| 1063703346 | Eric Brian Greenstone I | Respiratory Therapist, Registered | 167 N. Main Street, Tuba City, AZ 86045-0600 | 2011-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205434206 | Ambrielle Grace Begay | Specialist/Technologist | 48 Turquoise Drive, Tuba City, AZ 86045 | 2020-10-12 |
| 1063028124 | Fresenius Medical Care Tuba City, LLC | Clinic/Center | 50 S. Main Street, Ste 108, Tuba City, AZ 86045 | 2020-09-23 |
| 1609422484 | Rebekah Lee | Pharmacist | 167 North Main St. Tuba City Regional Health Care Corp., Tuba City, AZ 86045 | 2019-08-16 |
| 1861977050 | Kyle C Nguyen | Pharmacist | 3008 E. Birch Ave, Tuba City, AZ 86045 | 2018-10-03 |
| 1518419845 | John Glenn Ives | Pharmacist | 167 N, Main St, Tuba City, AZ 86045 | 2016-11-03 |
| 1497208433 | Toweringrock Non-emergency Medical Transport, LLC | Non-emergency Medical Transport (VAN) | 1029 E. Tc North Side Trailer, 36.153821-111.233925, Tuba City, AZ 86045 | 2016-07-26 |
| 1699153270 | Hopi Assisted Living Facility Inc. | Point of Service | 21 Senior Lane Upper Hud Housing Moenkopi, Hopi Assisted Living, Tuba City, AZ 86045 | 2015-05-14 |
| 1306223870 | Mia Seimy | Driver | Adair Avenue Space #5, Tuba City, AZ 86045 | 2015-05-04 |
| 1033507587 | Tari Carroll | Home Health Aide | Tumbleweed Drive Nha E-3, Tuba City, AZ 86045 | 2015-01-07 |
| 1023452984 | Amanda Bancroft Burrage | Pediatrics | 167 Main St., Tuba City, AZ 86045 | 2013-04-23 |
| Find all providers in zip 86045 | ||||
| Taxonomy Code | 172A00000X |
| Grouping | Other Service Providers |
| Classification | Driver |
| A person employed to operate a motor vehicle as a carrier of persons or property. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306223870 | Mia Seimy | Driver | Adair Avenue Space #5, Tuba City, AZ 86045 | 2015-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912508342 | Dbotc LLC | Driver | 20987 N John Wayne Pkwy # B104-289, Maricopa, AZ 85139-2926 | 2020-11-03 |
| 1578179552 | Joshua M Bearden | Driver | 8433 N Black Canyon Hwy Ste 180, Phoenix, AZ 85021-4800 | 2020-09-16 |
| 1235772658 | Michael James Johnson | Driver | 173 S 197th Dr, Buckeye, AZ 85326-3069 | 2019-10-18 |
| 1730670001 | Abdifatah Mohamed | Driver | 4040 E Mcdowell Rd Ste 313, Phoenix, AZ 85008-4447 | 2018-05-23 |
| 1942703921 | Mrt Transportation LLC | Driver | 320 S Nina Dr Ste 17, Mesa, AZ 85210-8466 | 2018-03-15 |
| 1417468075 | Mustafa Arbab | Driver | 2142 W Osborn Rd, Phoenix, AZ 85015-5731 | 2017-10-22 |
| 1750826566 | George Prempeh | Driver | 4512 W Donner Dr, Laveen, AZ 85339-4262 | 2017-01-03 |
| 1124574579 | Fitsum Abreha Sr. | Driver | 4760 N 28th St, Phoenix, AZ 85016-4846 | 2016-08-26 |
| 1154774107 | Dwight M Malone | Driver | 1505 N Country Club Dr Apt 118, Mesa, AZ 85201-2518 | 2016-07-14 |
| 1548627698 | Bouba Hamadou | Driver | 2602 W Kimberley St, Tucson, AZ 85705-1122 | 2016-01-20 |
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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.