Taxonomy Code 1710I1003X(1710i1003x)
Independent Duty Medical Technicians. Providers: 16

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Independent Duty Medical Technicians Providers

NPI Name Type Address

1164564639

MR. HEALTH SERVICES TECH Thomas James Miles

Individual

1222 Spruce St Rm 2.102a

Saint Louis, MO

1093940793

Haidee Hasty

Individual

331 Sijen Ave

Whiteman Afb, MO

1417182460

IDMT Jason Allen Miller

Individual

331 Sijen Ave

Whiteman Air Force Base, MO

1881829497

MR. IDMT Shane A Lacaillade

Individual

331 Sijan Ave

Whiteman Afb, MO

1316173313

Andrea Darcy Richards

Individual

331 Sijen Ave

Whiteman Afb, MO

1356667687

IDMT Benjamen E Pennington

Individual

310 Houx Dr

Whiteman Afb, MO

1598061269

MR. Marcus L Bell

Individual

126 Missouri Ave

Fort Leonard Wood, MO

1942568662

IDMT Jacob Daniel Rosko

Individual

539 Se Dd Hwy Lot 5

Warrensburg, MO

1821339268

IDMT Donald Gordon Berger II

Individual

208 March Dr

Whiteman Afb, MO

1346670551

Jessica A. Pownell

Individual

331 Sijen Ave

Whiteman Afb, MO

1689064875

IDMT Merlin Jewell

Individual

331 Sijen Ave

Whiteman Afb, MO

1780818229

IDMT Luis Hernandez

Individual

331 Sijen Ave

Whiteman Afb, MO

1992203764

Dylan John Kielcheski

Individual

331 Sijen Ave

Whiteman Afb, MO

1417576018

Zachory Woodard

Individual

331 Sijen Ave

Whiteman Air Force Base, MO

1538446018

MR. NREMT Zachary Lennon Bradley

Individual

400 E 9th St Ste 0040

Vha- Emergency Management

Kansas City, MO

1174889562

MILITARY PROVIDER Leticia Yvonne Brazil

Individual

331 Sijan Ave.

Whiteman Afb, MO

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