Juan Sebastian Vallejo

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

577 Sternberg Ave
Fort Eustis, VA 23604-5311

Phone

(757) 314-7924

NPI assigned

Jan 31, 2022

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

Electronic endpoints 1

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": "1643587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1801549811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 STERNBERG AVE",
            "city": "FORT EUSTIS",
            "state": "VA",
            "postal_code": "236045311",
            "telephone_number": "757-314-7924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 STERNBERG AVE",
            "city": "FORT EUSTIS",
            "state": "VA",
            "postal_code": "236045311",
            "telephone_number": "757-314-7924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLEJO",
        "first_name": "JUAN",
        "middle_name": "SEBASTIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-31",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://conus.dencom.army.mil/",
            "affiliation": "N",
            "endpointDescription": "Scheduler",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Scheduling PT Info",
            "address_1": "577 Sternberg Ave",
            "city": "Fort Eustis",
            "state": "VA",
            "country_code": "US",
            "postal_code": "236045311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Johnna Jolene Turner, RD, LD
• Bernadette Udeozor, NP
• Usameddac Ft Eustis VA
• Usv Optical Inc
• Stephanie Michelle Valentin
• Samara Williams Walker, RN
• Harry Lee Warren Jr., MD
• Glenda L. Watkins, OTD, MSOT, OTR/L
• Christine Mary Watson, OD
• Ramona L Watson, PH.D.

• Independent Duty Medical Technicians in Fort Eustis, VA
• Providers in Fort Eustis, VA by specialty
• Independent Duty Medical Technicians in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; 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.