Jesse Antonio Pacheco

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

Uscgc Escanaba
4000 Coast Guard Blvd
Portsmouth, VA 23703-2135

Phone

(757) 483-8431

NPI assigned

Jun 6, 2024

Last updated

Nov 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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": "1717632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1205678737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2494 BOYINGTON PL",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920201701",
            "telephone_number": "402-616-7892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "USCGC ESCANABA",
            "address_2": "4000 COAST GUARD BLVD",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237032135",
            "telephone_number": "757-483-8431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "JESSE",
        "middle_name": "ANTONIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-06",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Outland
• Michawn Overall, MD
• Michael D Owens, D.O.
• Toni Owens, PHARMD, RPH
• Francisca Ozoh
• Kenneth Allen Page, RN
• Marie Pais, PHARM D
• Justin George Palardy, MD
• Colette S Palmer, NP
• Deana Palmisano

• Independent Duty Corpsman in Portsmouth, VA
• Providers in Portsmouth, VA by specialty
• Independent Duty Corpsman in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.