Taxonomy Code 1710I1003X(1710i1003x)
Independent Duty Medical Technicians. Providers: 23

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Independent Duty Medical Technicians Providers

NPI Name Type Address

1134362510

IDMT Michele Suzanne Edmond

Individual

307 Boatner Rd

Suite 114

Eglin Afb, FL

1205079613

MRS. IDMT Jennifer Lynn Pope

Individual

307 Boatner Rd

Suite 114

Eglin Afb, FL

1912140328

MRS. IDMT Heather Elizabeth Johnson

Individual

307 Boatner Rd

Suite 114

Eglin Afb, FL

1942443338

IDMT Stephanie Nicole Newman

Individual

307 Boatner Rd

Eglin Afb, FL

1174766349

IDMT Karl Patrick Day

Individual

307 Boatner Rd

Suite 114

Eglin Afb, FL

1760625974

MR. IDMT Dexter Eli Vanderpool

Individual

101 Griffin Way

Eglin Afb, FL

1457595936

IDMT Amanda Eitel Ramsey

Individual

307 Boatner Rd

Suite 114

Eglin Afb, FL

1053545780

Daniel Pehrson

Individual

307 Boatner Rd

Suite 114

Eglin Afb, FL

1770717225

IDMT William L Newman

Individual

101 Griffin Way

Eglin Afb, FL

1700010196

IDMT James Jennings

Individual

307 Boatner Rd

Eglin Afb, FL

1447486857

IDMT Paul Richard Cadiz

Individual

307 Boatner Rd Ste 114

Eglin Afb, FL

1730491176

MR. IDMT Travis J Fritz

Individual

712 Osceola Cir

Eglin Afb, FL

1699208231

IDMT Dante Dubose

Individual

307 Boatner Rd

Eglin Afb, FL

1245701473

IDMT Marc Anthony Marrero

Individual

307 Boatner Rd

Eglin Afb, FL

1053870428

Albert Roy Schliesleder JR.

Individual

307 Boatner Rd

Eglin Afb, FL

1033671227

IDMT Stephen Thomas Biggs

Individual

307 Boatner Rd Ste 114

Eglin Afb, FL

1164666970

MRS. IDMT Andrea Charlene Nazario

Individual

307 Boatner Rd

Eglin Afb, FL

1376186213

IDMT, USAF Kayle Elizabeth Southerland

Individual

307 Boatner Rd

Eglin Afb, FL

1669012555

IDMT, USAF Jeremy Carmical

Individual

340 Boatner Rd

Eglin Afb, FL

1336774215

MR. OTHER Emanuel Leroy Lookadoo JR.

Individual

340 Boatner Rd

Eglin Afb, FL

How to obtain, renew, or terminate an NPI

Every health care provider, whether it’s a hospital, pharmacy, or individual specialist, must obtain their own NPI number. This identification number is unique and is assigned upon application. In tod...

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Taxonomy Code 1710I1003X
Specialization Independent Duty Medical Technicians
Display Name Independent Duty Medical Technicians
Taxonomy Group Other Service Providers
Taxonomy Classification Military Health Care Provider
Definition An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians.
Effective Date September 30, 2009
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Military Health Care Provider Codes

Independent Duty Corpsman

1710I1002X • providers: 3,002

Military Health Care Provider

171000000X • providers: 1,689