KEOKY DELAPENA (NPI# 1124619861) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124619861 |
| Entity Type | Individual |
| Full Name | KEOKY DELAPENA |
| Gender | Male |
| Credential | IDC STUDENT |
| Practice Address | 14101 Farenholt Avenue Bldg 14 San Diego CA 92134-5291 |
| Practice Telephone | 6195327968 |
| Mailing Address | 14101 Farenholt Avenue Bldg 14 San Diego CA 92134-5291 |
| Mailing Telephone | 6195327968 |
| Certification Date | 2021-01-26 |
| Enumeration Date | 2021-01-26 |
| Last Update Date | 2021-01-26 |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | Taxonomy Group | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|---|
| Y | 1710I1002X | Military Health Care Provider Specialization: Independent Duty Corpsman | Other Service Providers |
| Street Address | 14101 FARENHOLT AVENUE BLDG 14 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92134-5291 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932651148 | Casey Steele | Military Health Care Provider · Independent Duty Corpsman | Surface Warefare Medical Institute, 34101 Farenholt Avenue, Building 14, San Diego, CA 92134-5291 | 2016-11-04 |
| 1720345804 | Kyle Patrick Mcnamara | Military Health Care Provider | 34101 Farenholt Avenue, Building 14, San Diego, CA 92134-5291 | 2012-04-13 |
| 1609046432 | Carolyn Lababit Rodriguez | Radiologic Technologist | 34101 Fraenholt Avenue, Naval School of Health Sciences, San Diego, CA 92134-5291 | 2008-03-07 |
| 1023501301 | Jared Michael O'Brien | Military Health Care Provider · Independent Duty Corpsman | 34101 Farenholt Ave Bldg 14, San Diego, CA 92134-5291 | 2018-06-11 |
| 1407359763 | Frederick Roy Novella | Military Health Care Provider · Independent Duty Corpsman | 34101 Farenholt Ave Bldg 14, San Diego, CA 92134-5291 | 2018-03-13 |
| 1316440670 | Michael Anthony Anderson | Military Health Care Provider · Independent Duty Corpsman | 34101 Farenholt Ave Bldg 14, San Diego, CA 92134-5291 | 2018-03-13 |
| 1902304694 | Jason Douglas Beadore-Minoff | Military Health Care Provider · Independent Duty Corpsman | 34101 Farenholt Ave Bldg 14, San Diego, CA 92134-5291 | 2018-01-27 |
| 1356869473 | Thomas William Gordon | Military Health Care Provider · Independent Duty Corpsman | 34101 Farenholt Avenue, Building 14, San Diego, CA 92134-5291 | 2017-09-08 |
| 1154865764 | Priscilla Stephanie Alejo | Military Health Care Provider · Independent Duty Corpsman | 34101 Farenholt Ave Bldg 14, San Diego, CA 92134-5291 | 2016-12-15 |
| 1497298913 | Alan Aaron | Military Health Care Provider · Independent Duty Corpsman | 34101 Farenholt Ave, Building 14, San Diego, CA 92134-5291 | 2016-12-01 |
| Find all providers in zip 92134-5291 | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477178457 | Joseph Hunter Sampson | Military Health Care Provider · Independent Duty Corpsman | 34101 Farenholt Ave #14, San Diego, CA 92134 | 2020-06-15 |
| 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 |
| 1255870333 | Dosh Page | Physician Assistant | Swmi Farenholt Avenue, Building 14, San Diego, CA 92134 | 2017-02-22 |
| 1417328063 | Noem Clay Gallego | Military Health Care Provider · Independent Duty Corpsman | 34101 Building 14, Farenholt Avenue, San Diego, CA 92134 | 2015-10-08 |
| 1972999183 | Justin Paul Lachney | Military Health Care Provider · Independent Duty Corpsman | 34101 Farenholt Avenue, San Diego, CA 92134 | 2015-04-14 |
| 1174963532 | Ryan Anders Crane | Otolaryngology | Department of Otolaryngology - Nmc San Diego, 34800 Bob Wilson Dr, San Diego, CA 92134 | 2013-07-01 |
| 1447591268 | Amy B. Cornell | Student in an Organized Health Care Education/Training Program | 34800 Bob Wilson Drive, San Diego, Ca, Apo, AA 92134 | 2013-03-04 |
| 1841562956 | Christopher Patrick Androski Jr. | Emergency Medical Technician, Basic | Naval Medical Center San Diego 38400 Bob Wilson Dr, San Diego, CA 92134 | 2012-02-04 |
| 1164717740 | Jason James Weiner | Internal Medicine · Rheumatology | Dept of Internal Medicine, Division of Rheumatology, 34800 Bob Wilson Drive, San Diego, CA 92134 | 2011-06-13 |
| 1225320237 | Kimberly Ann Thompson | Student in an Organized Health Care Education/Training Program | Navy Medical Center San Diego Gme Department, 34800 Bob Wilson Dr., San Diego, CA 92134 | 2011-05-09 |
| Find all providers in zip 92134 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780274456 | Tinsae Tekleab | 2464 Fenton Pkwy Apt 308, San Diego, CA 92108-6704 | 2021-01-26 | |
| 1801492145 | Felicia Leanna Roberts | 2267 Reed Ave, San Diego, CA 92109-5628 | 2020-12-10 | |
| 1720684319 | Brandon Young | 3401 Farenholt Ave Building 14, San Diego, CA 92134-0001 | 2020-12-08 | |
| 1770180648 | Darius Lee Sean Woods | 6033 Sandy Shore Ct, San Diego, CA 92139-1014 | 2020-10-05 | |
| 1174130744 | Daniel Carrera | 2645 W Canyon Ave Apt 450, San Diego, CA 92123-4700 | 2020-09-28 | |
| 1316551740 | Kyle Bode Francis | 3149 Murray Ridge Rd, San Diego, CA 92123-2917 | 2020-09-02 | |
| 1255945069 | Jeremy Lee | 509 Dennery Rd Apt 145, San Diego, CA 92154-8542 | 2020-08-31 | |
| 1013520667 | Rashaad Brown | 4454 Cherokee Ave Apt 2, San Diego, CA 92116-3611 | 2020-08-24 | |
| 1932711934 | Alvaro Daniel Macias | 8685 Rio San Diego Dr Apt 4344, San Diego, CA 92108-6560 | 2020-08-20 | |
| 1255943635 | Stephon Peyton Frost | 2654 Mendonca Dr, San Diego, CA 92110-4263 | 2020-08-18 | |
| Find all providers in SAN DIEGO | ||||
| City | SAN DIEGO |
| Zip Code | 92134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922532035 | Samantha Delapena | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2017-04-14 |
| 1316939093 | David Delapena | Family Medicine | 1 Trillium Way, Suite 200, Corbin, KY 40701-8426 | 2005-08-18 |
| 1043204605 | Nicolas R Delapena | Internal Medicine · Infectious Disease | 3389 G St, Suite A, Merced, CA 95340-0964 | 2005-09-09 |
| 1861431439 | Michael Patrick Delapena | Optometrist | 419 E Romie Ln, Salinas, CA 93901-4016 | 2006-06-06 |
| 1861653016 | Josefina Delapena Tiu | Licensed Vocational Nurse | 8516 Schneple Dr, San Diego, CA 92126 | 2008-06-20 |
| 1649432659 | Lorena Delapena | Occupational Therapist | 80 Misty Morn Ln, Ewing, NJ 08638-1819 | 2008-06-30 |
| 1346630100 | Amanda Delapena | Pharmacy Technician | 306 Cromwell Ave, Staten Island, NY 10305-1312 | 2015-02-02 |
| 1821623281 | Rina Delapena | Nurse Practitioner | 5630 N Sheridan Rd Apt 319, Chicago, IL 60660-4810 | 2020-03-06 |
| 1790739373 | Leonor A Delapena | Anesthesiology | 200 High Service Ave, North Providence, RI 02904-5113 | 2006-05-19 |
| 1518081579 | Joseph J Marchionna Od and Michael Delapena Od A Poc | Optometrist | 419 E Romie Ln, Salinas, CA 93901-4016 | 2007-03-16 |
Please provide details on KEOKY DELAPENA by submitting the form below, or post on facebook comments.
Note that the information provided will be posted publicly on this web page. Please do not leave private contact information here. If you would like to contact us, please use this form.
| 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.