Taxonomy Code 1710I1003X(1710i1003x)
Independent Duty Medical Technicians. Providers: 113

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Independent Duty Medical Technicians Providers

NPI Name Type Address

1487998811

IDMT Benjamin D. Dellacca

Individual

101 Bodin Cir

60 Mdos/sgoe

Travis Afb, CA

1144454802

IDMT William Robert Cole

Individual

412 Mdg Edwards Afb Ca

Edwards Afb, CA

1639300197

IDMT Moises Velasco

Individual

412 Th Medical Group

30 Nightingale Rd.

Edwards Afb, CA

1851634026

IDMT Stephen Michael Wheeler

Individual

3828 Tyburn Dr

Beale Afb, CA

1629415260

Linda Guadalupe Moreno

Individual

101 Bodin Cir

Travis Afb, CA

1558700104

IDMT Tadd Olin Knox Ragsdale

Individual

3062 Troutman Dr

Beale Afb, CA

1720415664

IDMT Christopher Lawrence Dixon

Individual

101 Bodin Cir

Travis Afb, CA

1720401789

IDMT Glenn Wilson

Individual

101 Bodin Cir

Travis Afb, CA

1184047144

IDMT Austin Puente

Individual

1069 Butler Dr

Edwards, CA

1598182214

IDMT Matthew Wheaton Burns

Individual

105 Colorado St

Travis Afb, CA

1033527262

IDMT Timothy Eno

Individual

101 Bodin Cir

Travis Afb, CA

1093124398

IDC Benjamin Ryan Foy

Individual

2784 Hornet Way

San Diego, CA

1437551702

IDMT Jonathan Saplan

Individual

1411 Pelican Way

Suisun City, CA

1689076846

MR. James Easley JR.

Individual

4150 Clement St

San Francisco, CA

1922409655

IDMT Franklin Miranda

Individual

55 N Wolfe Ave

Edwards, CA

1548584378

IDMT Brian Caleb Greer

Individual

200 N Douglas St

El Segundo, CA

1013302546

IDMT Casey Pritchett

Individual

101 Bodin Cir

Travis Afb, CA

1861889297

IDMT Andrew Thompson

Individual

101 Bodin Cir

Travis Afb, CA

1023334158

MR. Billy L Fuson JR.

Individual

6656 Antigua Blvd

San Diego, CA

1114372786

MR. IDMT Adam George Hendriksen

Individual

483 N Aviation Blvd

El Segundo, CA

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