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

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Independent Duty Medical Technicians Providers

NPI Name Type Address

1104051812

Brian James Willberg

Individual

Psc 17

Box 134

Apo, AE

1881829497

MR. IDMT Shane A Lacaillade

Individual

331 Sijan Ave

Whiteman Afb, MO

1962637504

MR. IDMT Christopher Michael Lohr

Individual

102 Partridge Rd

Fayetteville, NC

1568697068

IDMT Jessica Serpa

Individual

383 Maynard St

Pope Afb, NC

1932334463

MR. IDMT Christopher Kevin Mclain

Individual

420 Post Ave

134th Medical Aid Station

Mcghee Tyson Airbase, TN

1689809055

MRS. IDMT Bethany Lynn Hagen Bowles

Individual

18 Amds Unit 5267

Apo, AP

1932335312

IDMT Deana Joy Dogherra

Individual

307 Boatner Rd Bldg 2825

Eglin, FL

1093941403

Ronnie O'dell Wright

Individual

Psc 112 Box 18

Apo, AE

1447486857

IDMT Paul Richard Cadiz

Individual

307 Boatner Rd Ste 114

Eglin Afb, FL

1851527279

MR. IDMT Nicanor Mercado Laudato JR.

Individual

4250 Griffiss Ave

Nellis Afb, NV

1043446396

MRS. IDMT Monica Theresa Suter

Individual

1618 Truemper St

Lackland A F B, TX

1891921193

IDMT Angela Leilani Quinones

Individual

4250 Griffiss Ave

Nellis Afb, NV

1811123128

IDMT Glen Robert Riley

Individual

420 Post Ave

Louisville, TN

1689800997

Monica Johnson

Individual

3278 Mitchell Blvd

Moody A F B, GA

1154557361

MR. IDMT Thomas James Allen

Individual

7196b Savannah St

Moody A F B, GA

1578799706

IDMT Herbert Lee Andrews II

Individual

1618 Truemper St

Lackland A F B, TX

1063648210

MRS. IDMT Bernadette Ann Vanness

Individual

1618 Truemper St

Lackland A F B, TX

1487880639

IDMT Tracy Badua

Individual

2506 Biggs St

37 Mdg/sghi

San Antonio, TX

1902032154

MR. IDMT Raymond Eric Garcia

Individual

7196b Savannah St

38th Rescue Squadron

Moody A F B, GA

1134355316

IDMT Richard Benkovics

Individual

5955 Zeamer Ave

3 Amds

Elmendorf Afb, AK

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