JERRY RAY BASKERVILLE (NPI# 1881781565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881781565 |
| Entity Type | Individual |
| Full Name | JERRY RAY BASKERVILLE |
| Credential | M.D. |
| Practice Address |
2003 W Avenue H Temple TX 76504-5256 |
| Mailing Address |
4500 Franklin Rd Troy TX 76579-3500 |
| Practice Telephone | 2547741880 |
| Practice Fax Number | 2063398755 |
| Mailing Telephone | 2547183142 |
| Mailing Fax Number | 2063398755 |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2016-08-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | G1607 | TX | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | G1607 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 105176503 | 05 |
| Street Address |
2003 W AVENUE H |
| City | TEMPLE |
| State | TX |
| Zip Code | 76504-5256 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902268345 | Caduceus Solutions, Pllc | Family Medicine | 2003 W Avenue H, Temple, TX 76504-5256 | 2016-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194243717 | Courtenay A Eddins | Occupational Therapy Assistant | 2010 Sw H K Dodgen Loop #201, Temple, TX 76504 | 2017-09-04 |
| 1891213500 | Melody Woods | Physical Therapy Assistant | 2010 Sw Hk Dodgen Loop, Suite 201, Temple, TX 76504 | 2017-09-01 |
| 1194255992 | Elizabeth Ford | Radiology | 202 Woodbridge Blvd 247, Temple, TX 76504 | 2017-06-14 |
| 1790223055 | Dinella Quinones | Specialist/Technologist | 2010 Sw Hkdodgen Loop, Suite 201, Temple, TX 76504 | 2017-02-07 |
| 1194277400 | Trina Morton | Specialist | 5297 S 31st Suite117a, Temple, TX 76504 | 2016-11-03 |
| 1134570922 | Plains Er Management Temple Ltd | Clinic/Center | 1551 W. Central Ave, Temple, TX 76504 | 2016-06-23 |
| 1962853770 | Express Er Temple, P.a. | Emergency Medicine | 1551 W. Central Avenue, Temple, TX 76504 | 2016-06-23 |
| 1306262548 | Nancy Lynne Sykes | Counselor | 2027 S 61st St Ste 121, Temple, TX 76504 | 2014-03-12 |
| 1972930683 | Taneka L Patrick | Social Worker | 2820 W Avenue O Ste B, Temple, TX 76504 | 2013-09-27 |
| 1255645990 | Mary Jane Ireland | Nurse Practitioner | 1901 Veterans Memorial Blvd, Temple, TX 76504 | 2010-08-05 |
| Find all providers in zip 76504 | ||||
| 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 |
|---|---|---|---|---|
| 1033566286 | Walk-in Clinic, LLC | Family Medicine | 1516 S 31st St, Suite B, Temple, TX 76504-6752 | 2016-05-18 |
| 1467815340 | Robert C Cortes | Family Medicine | 108 Tiger Cir, Temple, TX 76502-9219 | 2016-03-30 |
| 1306234521 | Heart of Texas Community Health Center, Inc. | Family Medicine | 600 S 25th St Ste 115, Temple, TX 76504-5227 | 2014-12-23 |
| 1215278882 | Manna Medical & Counseling | Family Medicine | 305 Carrollton Highway, Temple, GA 30178 | 2013-03-07 |
| 1619045499 | Bertram Vonzabern | Family Medicine | 311 Colburn Rd, Temple, NH 03084 | 2006-12-01 |
| 1588769871 | Alfredo Augusto Cisneros Sr. | Family Medicine | 1901 S 1st St (memorial Dr.), N/a, Temple, TX 76504 | 2006-09-13 |
| 1295795961 | Jennifer K. Flory | Family Medicine | 7556 Honeysuckle, Temple, TX 76502-5631 | 2006-03-25 |
| 1306805783 | Elizabeth W. Fomby | Family Medicine | 1402 W Avenue H, Temple, TX 76504-5342 | 2006-03-22 |
| 1205807120 | Esther Sun Lao | Family Medicine | 2420 Kingsbury Dr, Temple, TX 76502-7321 | 2006-01-30 |
| 1245226547 | Roger W. Kylberg | Family Medicine | 409 W Adams Ave, Temple, TX 76501-4211 | 2005-09-22 |
| Find all providers in TEMPLE | ||||
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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.