LOGAN TIMOTHY PETERSCHMIDT (NPI# 1962916841) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962916841 |
| Entity Type | Individual |
| Full Name | LOGAN TIMOTHY PETERSCHMIDT |
| Credential | HOSPITAL CORPSMAN |
| Practice Address |
2051 Cushing Rd San Diego CA 92106-6173 |
| Practice Telephone | 6195240418 |
| Enumeration Date | 2017-11-29 |
| Last Update Date | 2017-11-29 |
| 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 |
| Street Address |
2051 CUSHING RD |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92106-6173 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629052170 | Sung Wook Song | Family Medicine | 2051 Cushing Rd, San Diego, CA 92106-6173 | 2005-11-29 |
| 1154810182 | Jermaine Sarmiento Zosa | Licensed Vocational Nurse | 2051 Cushing Rd, San Diego, CA 92106-6173 | 2018-05-04 |
| 1699289462 | Teresita Salve Thompson | Licensed Vocational Nurse | 2051 Cushing Rd, San Diego, CA 92106-6173 | 2017-11-30 |
| 1134461569 | Camille Angela Robinson | Pediatrics | 2051 Cushing Rd, San Diego, CA 92106 | 2013-03-24 |
| 1023356110 | Navy Medical Center San Diego | Military Hospital | 2051 Cushing Rd, San Diego, CA 92106-6173 | 2013-01-23 |
| 1205174752 | Celso Villanueva Cayanan | Military Health Care Provider | 2051 Cushing Rd, San Diego, CA 92106-6173 | 2013-01-17 |
| 1477816213 | Nhu Quynh Do | Podiatrist | 2051 Cushing Rd, San Diego, CA 92106-6173 | 2012-06-18 |
| 1093088205 | Adam Michael Shults | Physician Assistant | 2051 Cushing Rd, San Diego, CA 92106-6173 | 2012-02-17 |
| 1093091605 | Marveluz Abad Verceles | Contractor | 2051 Cushing Rd, Naval Branch Health Clinic, Ntc, San Diego, CA 92106-6173 | 2011-10-26 |
| 1063792083 | Vanessa Wright | Nurse Practitioner | 2051 Cushing Rd, San Diego, CA 92106-6173 | 2011-08-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821650300 | Ktre1, LLC | Assisted Living Facility | 3219 Canon St., San Diego, CA 92106 | 2019-07-03 |
| 1093289910 | Ahsha Smith | Occupational Therapist | 2026 Roosevelt Road, #105, San Diego, CA 92106 | 2019-01-14 |
| 1710429147 | William Anthony Rodriquez | Social Worker | 140 Sylvester Ln. Building 500, Sarp Naval Base Pt Loma, San Diego, CA 92106 | 2016-11-16 |
| 1992123285 | Mark Wilson | Occupational Therapist | 2820 Roosevelt Road Ste 105, San Diego, CA 92106 | 2014-04-03 |
| 1659704542 | Sarah Hanem Izaguirre | Counselor | 2305 Historic Decatur Rd Ste 100, San Diego, CA 92106 | 2013-08-14 |
| 1285945451 | Danielle R Michaelis Castillo | Marriage & Family Therapist | 2305 Historic Decatur Rd., Suite 100, San Diego, CA 92106 | 2010-06-23 |
| 1588991145 | Philip Charles Rumsey | Dentist | 1050 Rosecrans St., Suite J, San Diego, CA 92106 | 2009-11-03 |
| 1801024575 | David Michael Spera | Dentist | 1050 Rosecrans, #j, San Diego, CA 92106 | 2009-07-01 |
| 1548408834 | Dolores Sanchez Pullen | Counselor | 1360 Rosecrans Street, Suite I, San Diego, CA 92106 | 2009-01-26 |
| 1215188362 | Jodi Lynn Ceballos | Psychologist | 2186 Historic Decatur Rd Unit 40, San Diego, CA 92106 | 2008-10-07 |
| Find all providers in zip 92106 | ||||
| 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 |
|---|---|---|---|---|
| 1629692389 | Christopher Matey | Military Health Care Provider | 34800 Bob Wilson Dr Ste 110, San Diego, CA 92134-1110 | 2020-05-29 |
| 1982225769 | Jin Ah Kim | Military Health Care Provider | Naval Medical Center San Diego 38400 Bon Wilson Drive, San Diego, CA 92134-5000 | 2020-05-03 |
| 1508495201 | Benjamin Michael Taylor | Military Health Care Provider | Naval Medical Center San Diego Psychiatry Residency Pgm, 34800 Bob Wilson Drive, San Diego, CA 92134 | 2020-04-04 |
| 1588292858 | Korina Erin Sandoval | Military Health Care Provider | Naval Medical Center Drive 38400 Bob Wilson Dr, San Diego, CA 92134-5000 | 2020-03-31 |
| 1033746508 | Hannah Johnson | Military Health Care Provider | 34800 Bob Wilson Dr Ste 403, San Diego, CA 92134-1403 | 2020-03-25 |
| 1891336541 | Prana Hands Nonprofit | Military Health Care Provider | 2180 Garnet Ave Ste 3l, San Diego, CA 92109-3676 | 2019-10-03 |
| 1992366587 | Darion Pegues | Military Health Care Provider | 3530 Kelsey St, San Diego, CA 92124-3516 | 2019-06-24 |
| 1083275762 | Tyler Bradshaw Thompson | Military Health Care Provider | 34, Farenholt Ave, San Diego, CA 92134-0001 | 2019-06-24 |
| 1558924274 | Nathan Alley-byrd | Military Health Care Provider | Navy Medical Center San Diego 34800 Bob Wilson Drive, San Diego, CA 92134-0001 | 2019-04-18 |
| 1013570290 | Mckennan A Cook | Military Health Care Provider | Nmcsd 34800 Bob Wilson Drive, San Diego, CA 92134-3300 | 2019-04-15 |
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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.