MRS. JERRICA MARIE WILD (NPI# 1003109844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1003109844 |
Entity Type | Individual |
Full Name | MRS. JERRICA MARIE WILD |
Practice Address |
15301 Warren Shingle Road Beale Afb CA 95903 |
Mailing Address |
15301 Warren Shingle Rd Beale Afb CA 95903-1907 |
Practice Telephone | 5306344738 |
Mailing Telephone | 5306344738 |
Enumeration Date | 2011-05-26 |
Last Update Date | 2011-11-22 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1710I1003X |
Military Health Care Provider Specialization: Independent Duty Medical Technicians |
Other Service Providers |
Street Address |
15301 WARREN SHINGLE ROAD |
City | BEALE AFB |
State | CA |
Zip Code | 95903 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700984853 | Kimberly D Kumer | Psychiatry & Neurology | 15301 Warren Shingle Road, Beale Afb, CA 95903 | 2006-09-20 |
1487799755 | Dianna M. Garbett | Counselor | 15301 Warren Shingle Road, 9 Mdos Sgohf, Beale Afb, CA 95903-1907 | 2007-02-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962575969 | Linda Lee Currier | Physical Therapist | 9 Medical Group, 15301 Warren Shingle Road, Beale Afb, CA 95903 | 2006-11-16 |
1780637124 | Lillie M Mells | Social Worker | 9mdos/sgoh, 15301 Warren Shingle Road, Beale Afb, CA 95903 | 2006-05-18 |
1962926907 | James Perman | Dentist | 15301 Warren Shingle Rd, Beale Afb, CA 95903 | 2017-08-01 |
1487990768 | Amy Abroms | Social Worker | 15301 Warren Shingle Rd, Beale Afb, CA 95903 | 2012-12-14 |
1568751378 | Sarah Elizabeth Avila | Family Medicine | 15301 Warren Shingle Rd, Beale Afb, CA 95903 | 2011-04-01 |
1396064218 | Thomas Michael Skinner | Family Medicine | 15301 Warren Shingle Rd, Beale Afb, CA 95903 | 2010-05-18 |
1306178900 | Kourtni Starkey | Preventive Medicine | 15301 Warren Shingle Rd, Beale Afb, CA 95903 | 2010-02-05 |
1972740728 | Enrilyn Robles Thronson | Pediatrics | 15301 Warren Shingle Rd, Beale Afb, CA 95903 | 2009-01-15 |
1205059508 | Sarah J Stringer | Psychiatry & Neurology | 15301 Warren Shingle Rd, Beale Afb, CA 95903 | 2007-04-11 |
1841372810 | Tony Joseph Eid | Pharmacist | 15301 Warren Shingle Rd, Beale Afb, CA 95903 | 2006-10-19 |
Find all providers in zip 95903 |
Taxonomy Code | 1710I1003X |
Grouping | Other Service Providers |
Classification | Military Health Care Provider |
Specialization | Independent Duty Medical Technicians |
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. |
Notes: Source: Air Force Surgeon General Office [7/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558700104 | Tadd Olin Knox Ragsdale | Military Health Care Provider | 3062 Troutman Dr, Beale Afb, CA 95903-2329 | 2013-06-17 |
1851634026 | Stephen Michael Wheeler | Military Health Care Provider | 3828 Tyburn Dr, Beale Afb, CA 95903-2254 | 2013-04-05 |
1750516530 | Tanisha E Harrison | Military Health Care Provider | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2009-05-21 |
1851526057 | Michell Marian Girton | Military Health Care Provider | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2009-05-18 |
1396988408 | Brian M Ritchie | Military Health Care Provider | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2009-04-20 |
1538302823 | James Thomas Feldhausen | Military Health Care Provider | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2009-04-16 |
1699918979 | Jenna Danielle Gasper | Military Health Care Provider | 15301 Warren Shingle Rd, Beale Afb, CA 95903-1907 | 2009-04-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366051294 | Ryan Allan Arriaga | Military Health Care Provider | 1000 Allison Dr, Vacaville, CA 95687-4975 | 2020-07-27 |
1851917165 | Katelyn Renee Watson | Military Health Care Provider | 101 Bodin Drive, Bldg 777, Fairfield, CA 95688 | 2020-06-23 |
1558911024 | Christopher Andersen | Military Health Care Provider | 1000 Allison Dr Apt 183, Vacaville, CA 95687-4988 | 2019-09-17 |
1558873968 | Giovanni Oddo | Military Health Care Provider | 25051 Mawson Dr, Laguna Hills, CA 92653-5263 | 2017-10-26 |
1730606658 | Jeffrey Rodriguez | Military Health Care Provider | 975 Carl Cir, Edwards, CA 93523-1906 | 2017-08-23 |
1154847960 | James Edward Schafer | Military Health Care Provider | 883 Covey Ct, Hollister, CA 95023-8906 | 2017-08-15 |
1437551702 | Jonathan Saplan | Military Health Care Provider | 1411 Pelican Way, Suisun City, CA 94585-2330 | 2014-09-18 |
1093124398 | Benjamin Ryan Foy | Military Health Care Provider | 2784 Hornet Way, San Diego, CA 92106-6421 | 2014-08-12 |
1598182214 | Matthew Wheaton Burns | Military Health Care Provider | 105 Colorado St, Travis Afb, CA 94535-1255 | 2014-03-19 |
1508282658 | April Summers | Military Health Care Provider | 2205 Farrell Ave Apt 204, Redondo Beach, CA 90278-1846 | 2014-03-13 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.