Taxonomy Code 1710I1003X(1710i1003x)
Independent Duty Medical Technicians. Providers: 22

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Independent Duty Medical Technicians Providers

NPI Name Type Address

1043453129

MRS. IDMT Jessica S Eby

Individual

2501 Capehart Rd

Flight Medicine

Offutt A F B, NE

1942434352

Richelle Leigh Moen

Individual

105 Grant Cir

Suite 133

Offutt A F B, NE

1508091505

Jan Fink

Individual

105 Grant Cir

Bldg 527 Suite 133

Offutt A F B, NE

1245465137

IDMT Gregory Royce Beavers

Individual

2501 Capehart Rd

Offutt A F B, NE

1669608774

IDMT Charles Curtis Ruggles

Individual

105 Grant Cir

Bldg 527, Suite 133

Offutt A F B, NE

1407082522

IDMT Claude Alan Russo

Individual

2501 Capehart Rd

Sgopf

Offutt A F B, NE

1790912608

MR. IDMT Brian David Cooprider

Individual

2501 Capehart Road

Bellevue, NE

1255561973

MRS. IDMT Karolyn A Harris

Individual

105 Grant Cir

Ste 133

Offutt A F B, NE

1659514057

MR. IDMT Joey Depositar Torres

Individual

105 Grant Cir

Building 527, Suite 133

Offutt A F B, NE

1427355866

IDMT Andrea Jefferson

Individual

2501 Capehart Rd

Offutt A F B, NE

1295026219

IDMT Keoshia S Coleman

Individual

6941 Florence Blvd

Omaha, NE

1619111895

Jacquelene Sheree Cota

Individual

2501 Capehart Rd

Offutt A F B, NE

1679829220

IDMT Ryan Thomas Rubino

Individual

12102 Larson Cir

Bellevue, NE

1457697872

MRS. IDMT Maria G Wiest

Individual

12222 S 25th Ave

Bellevue, NE

1720302557

IDMT Alicia Michelle Chavez

Individual

705 Donegal Dr

Papillion, NE

1245536994

IDMT Aaron Bradley Smith

Individual

Ehrling Bergquist Clinic

2501 Capehart Rd

Offutt Afb, NE

1366901738

Taten Brent Swanson

Individual

2501 Capehart Rd

Offutt Afb, NE

1902496326

IDMT Austin Barrett Shepherd

Individual

2501 Capehart Rd

Bellevue, NE

1770894966

IDMT Kelli E. Vanpelt

Individual

2501 Capehart Rd

Offutt Afb, NE

1740947506

MR. Vincent Walker JR.

Individual

5411 N 129th St

Omaha, NE

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