Taxonomy Code 1710I1003X(1710i1003x)
Independent Duty Medical Technicians. Providers: 6

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Independent Duty Medical Technicians Providers

NPI Name Type Address

1881905073

IDMT Chun Chung Fong

Individual

3278 Mitchell Blvd Bldg 900

Moody Afb, GA

1063646230

MR. IDMT James Michael White

Individual

3278 Mithell Blvd

Bldg. 900

Moody Afb, GA

1568909091

IDMT Bailey Holt

Individual

3278 Mitchell Blvd

Moody Afb, GA

1831725381

Bradley James Connahey

Individual

3278 Mitchell Blvd

Moody Afb, GA

1912392333

Jennifer Anderson

Individual

7196 B Savannah St

Moody Afb, GA

1982120796

IDMT Byron Reed

Individual

3278 Mitchell Blvd

Moody Afb, GA

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