MATTHEW PHILIP SCULLY (NPI# 1013256536) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013256536 |
| Entity Type | Individual |
| Full Name | MATTHEW PHILIP SCULLY |
| Credential | IDMT |
| Practice Address |
4881 Sugar Maple Dr Wright Patterson Afb OH 45433-5529 |
| Mailing Address |
4061 Cloud Park Dr Aprt B-2 Huber Heights OH 45424-8084 |
| Practice Telephone | 6167170169 |
| Mailing Telephone | 6167170169 |
| Enumeration Date | 2013-02-04 |
| Last Update Date | 2013-02-04 |
| Gender Code | M |
| 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 |
4881 SUGAR MAPLE DR |
| City | WRIGHT PATTERSON AFB |
| State | OH |
| Zip Code | 45433-5529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104442813 | Michael Anthony Salerno | Military Health Care Provider | 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 | 2020-06-18 |
| 1780209957 | Stacey O'donnell | Nurse Anesthetist, Certified Registered | 4881 Sugar Maple Dr, 88mdg/sgcj, Wright Patterson Afb, OH 45433 | 2020-06-12 |
| 1043834328 | William Woodfin Crosby | Nurse Practitioner | 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 | 2020-06-03 |
| 1447872833 | Dayton Vamc | Clinic/Center | 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 | 2020-05-08 |
| 1629697750 | Firas Zako | Dentist | 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 | 2020-04-09 |
| 1235768540 | Jacob David Harley | Dentist | 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 | 2020-04-07 |
| 1326696527 | Rebecca Noel Seagraves | Pharmacist | 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 | 2019-08-30 |
| 1154974095 | Lori Saturley | Dental Hygienist | 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 | 2019-07-19 |
| 1902463987 | Stephen Seth Childers | Dentist | 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 | 2019-05-24 |
| 1306409479 | Sean Roberts | Dentist | 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 | 2019-04-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891289518 | Sara Lyons | Physician Assistant | 88 Mdj/sghj, 4881 Sugar Maple Dr, Wright-patterson Afb, OH 45433 | 2018-06-16 |
| 1073001558 | Mega Margapuram | Student in an Organized Health Care Education/Training Program | 1 Sugar Maple Drive, Dayton, OH 45433 | 2018-04-30 |
| 1437667979 | Michael Peter Dring | Social Worker | Building 830, Credentials Office, 4881 Sugar Maple Rd, Wpafb, OH 45433 | 2018-01-18 |
| 1316486814 | Josiah Hardin | Internal Medicine | 88 Mdos/sgomi, 4881 Sugar Maple Dr., Wright-patterson Afb, OH 45433 | 2017-02-16 |
| 1780137380 | Allison Osterfeld | Pharmacist | 88 Mdg 4881 Suga Maple Dr, Wright Patterson Afb, OH 45433 | 2016-07-29 |
| 1891144283 | Kyle Harris | Student in an Organized Health Care Education/Training Program | 4481 Sugar Maple Dr., Wright Patterson Afb, OH 45433 | 2016-06-07 |
| 1245601756 | Nichole Griep | Audiologist | 88 Mdg/sgpq, 4881 Sugar Maple Dr, Wright-patterson Afb, OH 45433 | 2015-10-09 |
| 1487021267 | Melanie Schaffer | Dietitian, Registered | 4881 Sugamaple Drive, Wpafb, OH 45433 | 2015-08-27 |
| 1831582261 | Joseph K Wray | General Practice | 88 Mdg/sgcj, 4881 Sugar Maple Dr., Wright-patterson Afb, OH 45433 | 2015-03-10 |
| 1659798031 | Maninder Kaur | Nurse Practitioner | 88 Mdos/sgom, 4881 Sugar Maple Drive, Wright Patterson Afb, OH 45433 | 2014-03-24 |
| Find all providers in zip 45433 | ||||
| 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 |
|---|---|---|---|---|
| 1104442813 | Michael Anthony Salerno | Military Health Care Provider | 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 | 2020-06-18 |
| 1861954059 | Bryan Thomas Courtney | Military Health Care Provider | 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 | 2019-04-05 |
| 1558714428 | Rodney Bosserman | Military Health Care Provider | 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 | 2016-07-15 |
| 1215395561 | Cassidy Lee Mccurdy | Military Health Care Provider | 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 | 2016-02-02 |
| 1740664044 | Addison Gregory Stemmer | Military Health Care Provider | 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 | 2015-07-16 |
| 1538396809 | Paul Richard Mccracken | Military Health Care Provider | 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5546 | 2009-06-15 |
| 1962638759 | Charity E Green | Military Health Care Provider | 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5546 | 2009-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992305700 | Jason Patrick Scoles | Military Health Care Provider | 5607 Hickam Dr, Dayton, OH 45431-1544 | 2020-10-30 |
| 1497380364 | Sean Francis Costello | Military Health Care Provider | 4884 Sugar Maple Dr, Wpafb, OH 45433-5533 | 2020-03-11 |
| 1902449846 | Brandi Krueger-dunn | Military Health Care Provider | 4206 Redfern Rd, Parma, OH 44134-3364 | 2019-10-23 |
| 1821500232 | Jacob Tyler Weaver | Military Health Care Provider | 7320 Canterbury Ct, Liberty Township, OH 45044-9227 | 2017-10-26 |
| 1538585682 | Brian Milner | Military Health Care Provider | 9910 Sherwood Dr, Cincinnati, OH 45231-2526 | 2014-03-13 |
| 1184063729 | Jasom Robert Kidnocker | Military Health Care Provider | 37 Rookwood Dr, Chillicothe, OH 45601-3085 | 2013-06-17 |
| 1629312988 | Jack Williams | Military Health Care Provider | 116 Dickman Dr, Dayton, OH 45431-1570 | 2012-11-26 |
| 1760726178 | Christy Wade | Military Health Care Provider | 19404 Harl Weiller Rd, Caldwell, OH 43724-9149 | 2012-11-26 |
| 1962775890 | Nicole Marie Palko | Military Health Care Provider | 1104 Middy Dr, Dayton, OH 45433-1322 | 2012-02-23 |
| 1326339334 | Brian J Kemp | Military Health Care Provider | 5823 Gross Dr, Dayton, OH 45431-1515 | 2011-04-25 |
| Find all providers with the same taxonomy | ||||
| City | WRIGHT PATTERSON AFB |
| Zip Code | 45433 |
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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.