Taxonomy Code 1710I1003X(1710i1003x)
Independent Duty Medical Technicians. Providers: 18

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Independent Duty Medical Technicians Providers

NPI Name Type Address

1639313240

IDMT Raymond J Flaiz

Individual

312 W. Losey Str

375 Mdg/sgopg

Scott Afb, IL

1922232909

IDMT Ryan Michael Davis

Individual

310 W Losey St

Scott Afb, IL

1164656088

IDMT Andrew Zavala

Individual

310 W Losey St

375th Mdg/sgopg

Scott Afb, IL

1184858045

IDMT Timothy Blake Wilder

Individual

310 W Losey St

Scott Afb, IL

1255565149

MR. IDMT Clyde Nobles JR.

Individual

375 Mdg

Scott Afb, IL

1861627804

MR. IDMT Mark Winthrop Battle

Individual

2318 Rockwood Dr

Belleville, IL

1477784312

IDMT Derek Cowen

Individual

505 Rimkus Drive

Scott Air Force Base, IL

1770818056

MR. IDMT Patrick Christopher Korthuis

Individual

2400 East Dr

Bldg 3650 Rm 135

Scott Afb, IL

1245540772

MRS. IDMT Valerie Veronica Lee

Individual

210 N Point Rd

Fairview Heights, IL

1487998746

IDMT Melissa Dawn Goff

Individual

310 West. Losey Street

Scott Afb, IL

1912328857

Justin Stinson

Individual

7526 S Clyde Ave

Chicago, IL

1275954125

IDMT D'mario Revere

Individual

4465 George Washington Dr

Scott Afb, IL

1043787468

Zachary B Reynolds

Individual

4691 Petty Ct

Scott Afb, IL

1528539756

IDMT Joe Calvin Durham II

Individual

310 W Losey St

Scott Afb, IL

1063975001

MR. IDMT Collin Schroeder

Individual

310 W Losey St

Scott Afb, IL

1215580386

IDMT Ryan Taylor Blalock

Individual

310 W Losey St

Scott Afb, IL

1346890894

Crystal June Garcia

Individual

310 W Losey St

Scott Afb, IL

1437778016

Mark Alan Underhill

Individual

310 W Losey St

Scott Afb, IL

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