Active NPI
Colton Ken Dessert
- Military Health Care Provider
- Jbsa Lackland, TX
National Provider Identifier
1750959110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Military Health Care Provider
- Practice address
- 2200 Bergquist Dr Ste 1
Jbsa Lackland, TX 78236-9908 - Phone
- (210) 292-7412
- NPI assigned
- Jun 14, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | Primary |
Addresses
Primary practice location
2200 Bergquist Dr Ste 1
Jbsa Lackland, TX 78236-9908
Mailing address
9132 Truemper Street
Unit 9132
Lackland Afb, TX 78236
Phone (916) 865-7567
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | Colton.k.dessert.mil@mail.mil | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623628800000",
"number": "1750959110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9132 TRUEMPER STREET",
"address_2": "UNIT 9132",
"city": "LACKLAND AFB",
"state": "TX",
"postal_code": "78236",
"telephone_number": "916-865-7567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 BERGQUIST DR STE 1",
"city": "JBSA LACKLAND",
"state": "TX",
"postal_code": "782369908",
"telephone_number": "210-292-7412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESSERT",
"first_name": "COLTON",
"middle_name": "KEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-14",
"last_updated": "2021-06-14",
"certification_date": "2021-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "Colton.k.dessert.mil@mail.mil",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2200 Bergquist Dr Ste 1",
"city": "Jbsa Lackland",
"state": "TX",
"country_code": "US",
"postal_code": "782369908",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Jbsa Lackland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.