Taxonomy Code 1710I1003X(1710i1003x)
Independent Duty Medical Technicians. Providers: 4

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Independent Duty Medical Technicians Providers

NPI Name Type Address

1730273038

MISS HS3 Heather Marita Niccoli

Individual

2420 S Lincoln Memorial Dr

Uscg Sector Lake Michigan-medical

Milwaukee, WI

1932333945

IDMT Brett Hunter

Individual

100 Independence Dr

Medical Aid Station, Bldg 418

Camp Douglas, WI

1760752752

IDMT Lauren E Prusky

Individual

80 Johnson Ave

Oshkosh, WI

1821424441

IDMT David Thao

Individual

1231 Monroe St

Wausau, WI

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