Taxonomy Code 1710I1003X(1710i1003x)
Independent Duty Medical Technicians. Providers: 1,299

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Independent Duty Medical Technicians Providers

NPI Name Type Address

1619101870

IDMT John Michael Cronin

Individual

35 Mdg

Misawa Ab, Japan

Apo, AP

1851525026

MR. IDMT Thomas Glennon Moore

Individual

6475 Warrior Way

Bldg. 1938

Hill Afb, UT

1477787653

MR. IDMT Nicholas Todd Wentworth

Individual

113 Lielmanis Ave

Hurlburt Field, FL

1306070511

MRS. Abigail Rivera

Individual

101 Bodin Cir

Travis Afb, CA

1487888699

IDMT Nicholson Adolfo Borja

Individual

101 Bodin Cir

60th Amds/sgpf

Travis Afb, CA

1306070446

MRS. IDMT Brandi Adele Mackey

Individual

84 Bomber Rd

Mountain Home A F B, ID

1942434089

MS. IDMT Adrienne Rose Vera-mahaffey

Individual

101 Bodin Cir

Travis Afb, CA

1558595694

IDMT Eric Louis Abram

Individual

101 Bodin Cir

60 Amds/ Sgpf

Travis Afb, CA

1467686501

MRS. IDMT Vanity Shaneka Davis

Individual

101 Bodin Cir

Sgpf

Travis Afb, CA

1154555225

IDMT Claude Lyman Weidow

Individual

939 Missile Rd

Ste 3

Sheppard Afb, TX

1922232099

IDMT Pocco S Bussey

Individual

92 Medical Group, Flight Medicine Clinic

Fairchild, WA

1487888574

IDMT Tommy Nelson Belcher

Individual

1090 Arnold Dr

Little Rock Afb, AR

1366676462

IDMT Bobbi Gabriele Kennedy

Individual

6801 Ne Cornfoot Road

Portland, OR

1568696599

MRS. IDMT Deborah Ann Ciesla

Individual

7985 Browning St Bldg 1781

Hill Afb, UT

1881828812

IDMT Kellie Boisse

Individual

4700 Las Vegas Blvd N

Nellis Afb, NV

1952535924

IDMT Kevin J. Mathews

Individual

Psc 1 Box 351

Apo, AE

1922232909

IDMT Ryan Michael Davis

Individual

310 W Losey St

Scott Afb, IL

1972737971

MR. IDMT Ian E Coon

Individual

1618 Truemper St

Lackland A F B, TX

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

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