JEFFERY MITSCHKE (NPI# 1073052965) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073052965 |
| Entity Type | Individual |
| Full Name | JEFFERY MITSCHKE |
| Credential | IDMT |
| Practice Address |
149 G W Hart St Sheppard Afb TX 76311-3430 |
| Practice Telephone | 9406765972 |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2017-02-13 |
| 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 |
149 G W HART ST |
| City | SHEPPARD AFB |
| State | TX |
| Zip Code | 76311-3430 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740792076 | Hunter Tristan Justice Ferguson | Military Health Care Provider | 527 I Ave Unit 72, Sheppard Afb, TX 76311 | 2017-10-26 |
| 1588083356 | Keenan David Atwood | Emergency Medicine | 145 Hart St, Aerospace Medicine Clinic, Sheppard Afb, TX 76311 | 2014-04-09 |
| 1649525338 | Austin Douglas Solomons | Social Worker | 82 Medical Group, 149 Hart Street, Sheppard Afb, TX 76311 | 2012-07-18 |
| 1700162831 | Kristina Marie Zuccarelli | Student in an Organized Health Care Education/Training Program | 132 Hart Street, Sheppard Afb, TX 76311 | 2011-11-03 |
| 1679859367 | Brandon William Keyser | Dentist | 82 Dental Squadron/sgd, 149 Hart St Ste 4, Sheppard Afb, TX 76311 | 2011-10-26 |
| 1437456373 | Jennifer Leigh Noblin | Military Health Care Provider | Sheppard Afb Mental Health Clinic, 149 Hart St. Bldg 1200, Wichita Falls, TX 76311 | 2011-02-11 |
| 1336450444 | Allen Chan | Dentist | 82nd Medical Group (aetc) Pas: Sq0jfb5d, Sheppard Afb, Apo, AA 76311 | 2010-06-24 |
| 1003140344 | Christopher Shawn Couch | Military Health Care Provider | 718 I Ave 82 Mss/dpf, Bldg 1900 Dept Xufb, Sheppard Afb, TX 76311 | 2009-09-18 |
| 1124255583 | Danny Lee Dennis Jr. | Military Health Care Provider | 939 Missile Road Bld 1900, Wichita Falls, TX 76311 | 2009-06-12 |
| 1902008980 | Jason West Cromar | Military Hospital | 149 G W Hart St., Bldg. 1200, 82 Mdg/sgp, Sheppard Afb, TX 76311 | 2007-06-01 |
| Find all providers in zip 76311 | ||||
| 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 |
|---|---|---|---|---|
| 1740792076 | Hunter Tristan Justice Ferguson | Military Health Care Provider | 527 I Ave Unit 72, Sheppard Afb, TX 76311 | 2017-10-26 |
| 1003140344 | Christopher Shawn Couch | Military Health Care Provider | 718 I Ave 82 Mss/dpf, Bldg 1900 Dept Xufb, Sheppard Afb, TX 76311 | 2009-09-18 |
| 1801129887 | Jamie Sampson | Military Health Care Provider | 939 Missile Rd Ste 1062, Sheppard Afb, TX 76311-2263 | 2009-09-09 |
| 1093949091 | Aimee Lynn Arendes | Military Health Care Provider | 149 Hart St Bldg 1200, Sheppard Afb, TX 76311-3430 | 2009-05-06 |
| 1982908398 | Christina Q Parker | Military Health Care Provider | 149 Hart St, 82 Mdos, Sheppard Afb, TX 76311 | 2010-12-28 |
| 1154559557 | Lisa Cathleen Richards | Military Health Care Provider | 149 Hart St, 82 Mdg/mdos, Sheppard Afb, TX 76311-3477 | 2009-06-24 |
| 1154555225 | Claude Lyman Weidow | Military Health Care Provider | 939 Missile Rd, Ste 3, Sheppard Afb, TX 76311-2263 | 2009-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453145 | Ian Frogley | Military Health Care Provider | Jbsa 2230 Hughes Ave, San Antonio, TX 78236-8404 | 2020-10-06 |
| 1861099939 | Andrew Goebel | Military Health Care Provider | 1800 Truemper St, San Antonio, TX 78236-5510 | 2020-10-02 |
| 1790382844 | Kyle Schachsieck | Military Health Care Provider | 2800 Winfield Scott Rd Ste 347, Fort Sam Houston, TX 78234-7662 | 2020-10-01 |
| 1861018178 | John C Gallik | Military Health Care Provider | 3176 Corporal Johnson Road, Jbsa Fort Sam Houston, TX 33809 | 2020-06-23 |
| 1376169086 | Colton Wayne Dickens | Military Health Care Provider | 5415 N Foster Rd Apt 8306, San Antonio, TX 78244-2405 | 2020-06-18 |
| 1750924692 | Michelle Lynn Hernando | Military Health Care Provider | 109 Kentucky St, Dyess Afb, TX 79607-1007 | 2019-10-23 |
| 1598315061 | Matthew Scott Floores | Military Health Care Provider | 7303 S Ute Trl, Austin, TX 78729-7756 | 2019-09-17 |
| 1427529650 | Riley Pearl Solomon | Military Health Care Provider | 6419 N Vandiver Rd Apt 2203, Alamo Heights, TX 78209-4484 | 2018-12-16 |
| 1588135719 | Alejandro Daniel Perez | Military Health Care Provider | Wilderness Trl & Camp Bullis, San Antonio, TX 78257 | 2018-12-16 |
| 1861969271 | Jose A Sanchez | Military Health Care Provider | 15425 Bobwhite Quail, San Antonio, TX 78253-6621 | 2018-10-24 |
| Find all providers with the same taxonomy | ||||
| City | SHEPPARD AFB |
| Zip Code | 76311 |
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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.