Jeremy Forrest Gleason

Primary specialty

Military Health Care ProviderTaxonomy code 171000000X

Practice address

45 Worchester Ave
Joint Base Pearl Harbor- Hickam, HI 96853

Phone

(361) 362-8275

NPI assigned

Dec 17, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1639699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1063171064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1778 ALA MOANA BLVD APT 2517",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968151624",
            "telephone_number": "361-362-8275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 WORCHESTER AVE",
            "city": "JOINT BASE PEARL HARBOR- HICKAM",
            "state": "HI",
            "postal_code": "96853",
            "telephone_number": "361-362-8275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEASON",
        "first_name": "JEREMY",
        "middle_name": "FORREST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-17",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Lynn Hendrickson
• Benjamin Hubler
• Jamie Liz E Maron
• Hoon Min, DMD
• Victorina Nugent

• Military Health Care Provider in Joint Base Pearl Harbor- Hickam, HI
• Providers in Joint Base Pearl Harbor- Hickam, HI by specialty
• Military Health Care Provider in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.