JONATHAN BAXTER (NPI# 1932475845) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932475845 |
| Entity Type | Individual |
| Full Name | JONATHAN BAXTER |
| Credential | DO |
| Practice Address |
355th Medical Group 4175 S Alamo Ave Tucson AZ 85707 |
| Mailing Address |
4175 South Alamo Ave Tucson AZ 85707-4405 |
| Practice Telephone | 5202282778 |
| Mailing Telephone | 5202282778 |
| Enumeration Date | 2012-03-25 |
| Last Update Date | 2020-09-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171000000X | Military Health Care Provider | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1052 Quail Valley Dr, Provo, UT 846045209 | 8018369334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760618417 | Jonathan R Baxter | Counselor | 1620 Massachusetts Ave Ste 10, Lexington, MA 02420-3826 | 2009-06-09 |
| Street Address |
355TH MEDICAL GROUP 4175 S ALAMO AVE |
| City | TUCSON |
| State | AZ |
| Zip Code | 85707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366438962 | David Michael Dennison | Dentist | 355th Medical Group, 4175 S. Alamo Ave, Tucson, AZ 85707-4406 | 2005-09-20 |
| 1538545587 | Cristel Alcocer | Psychologist | 355th Medical Group, 4175 S. Alamo Ave., Tucson, AZ 85707-4405 | 2015-07-31 |
| 1346629052 | Kristie Lynn Partin-agarwal | Dentist | 355th Medical Group, 4175 S. Alamo Ave, Tucson, AZ 85707 | 2015-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699128850 | Megan Dehaven | Specialist/Technologist | 5455 E Comanche St, Tucson, AZ 85707 | 2016-07-22 |
| 1780927954 | Ryan N Taylor | Physician Assistant | 400, 4175 S Alamo Ave, Davis-monthan Afb, AZ 85707 | 2013-04-05 |
| 1154658839 | Alisha A Marchetti | Physician Assistant | 4175 S. Alamo Avenue, 355th Mdg/mdos, Davis-monthan Afb, AZ 85707 | 2009-11-17 |
| 1851529192 | Christopher Thomas Yarbrough | Military Health Care Provider | 4625 South Phoenix Street Bldg 4843, Tucson, AZ 85707 | 2009-06-25 |
| 1144457045 | Denise Fabian | Psychiatry & Neurology | 5427 E. Madera Street, Davis Monthan Afb, AZ 85707 | 2009-06-17 |
| 1942437447 | Emerson M Earle | Military Health Care Provider | 4625 S. Phoenix St, Bld 4843, Tucson, AZ 85707 | 2009-06-11 |
| 1164657136 | Raul Romero | Military Health Care Provider | 4575 S. Phoenix St. 563rd Oss, Dmafb, AZ 85707 | 2009-05-20 |
| 1063647196 | Virginia E. Bailey | Military Health Care Provider | 4837 S Phoenix St., Rm 119 Davis-monthan Air Force Base, Tucson, AZ 85707 | 2009-05-19 |
| 1043417611 | Jacob Riis | Orthopaedic Surgery | 355 Mdg, 4175 South Alamo Ave, Tucson, AZ 85707 | 2007-06-28 |
| 1508989732 | Christopher E. Dunham | Physician Assistant | 4175 S. Alamo Ave Bldg 400, 355th Medical Group-davis Monthan Afb, Tucson, AZ 85707 | 2007-04-10 |
| Find all providers in zip 85707 | ||||
| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760956387 | Kyle Lynn Craver | Military Health Care Provider | 4175 S Alamo Ave, Tucson, AZ 85707 | 2019-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477112290 | Erica Thomas | Military Health Care Provider | 2501 N 4th St Ste 15, Flagstaff, AZ 86004-3701 | 2019-06-06 |
| 1104399641 | Kym Family LLC | Military Health Care Provider | 6732 E Moreland St, Scottsdale, AZ 85257-3246 | 2019-01-08 |
| 1770024986 | Aaron Craig Andrew Hassad | Military Health Care Provider | 2989 East Arow Street, Yuma, AZ 85369 | 2017-03-20 |
| 1922428671 | Sandra Pratt | Military Health Care Provider | 1941 W Dineh Dr, Prescott, AZ 86305-3910 | 2014-04-21 |
| 1306928858 | Anne T Ballinger | Military Health Care Provider | 2240 Winrow Avenue, Usa Meddac,rwbahc, Fort Huachuca, AZ 85613-7079 | 2006-10-20 |
| 1417483074 | Matthew Collins | Military Health Care Provider | 7219 N Litchfield Rd, Luke Afb, AZ 85309-1529 | 2017-05-02 |
| 1770663833 | Henry Hugh Canton | Military Health Care Provider | 2240 Winrow Ave, Usa Meddac, Rwbahc, Ft. Huachuca, AZ 85613-7079 | 2006-10-16 |
| 1104928662 | Martha Leticia Gonzalez | Military Health Care Provider | 6950 E Williams Field Rd, Mesa, AZ 85212-6033 | 2006-09-03 |
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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.