MR. THOMAS HARRISON GENTRY III (NPI# 1194932673) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194932673 |
| Entity Type | Individual |
| Full Name | MR. THOMAS HARRISON GENTRY III |
| Credential | IDC |
| Practice Address |
110 Fieldcrest Dr Jacksonville NC 28546-9673 |
| Practice Telephone | 9104508054 |
| Practice Fax Number | 9104508053 |
| Mailing Telephone | 9104508054 |
| Mailing Fax Number | 9104508053 |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2007-07-08 |
| 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 |
110 FIELDCREST DR |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28546-9673 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316578388 | Judylyn Hobson | Registered Nurse | Pride In North Carolina, LLC, 3886 Henderson Dr, Jacksonville, NC 28546 | 2020-01-29 |
| 1427694637 | Aaron Patrick Bettcher | Military Health Care Provider | 3rd Mrb Loop Rd, Camp Lejeune, NC 28546 | 2019-11-22 |
| 1962044289 | Levi Scott Marshall | Military Health Care Provider | Everett Creek Road, Building 612, Camp Lejeune, NC 28546 | 2019-10-09 |
| 1649826652 | Nicholas Otazo | Military Health Care Provider | 3rd Mrb 20073, Camp Lejeune, NC 28546 | 2019-08-15 |
| 1417519570 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2001 Marlin Drive Unit 100, Jacksonville, NC 28546 | 2019-06-28 |
| 1023500212 | Josip Ninrodriguez | Military Health Care Provider | 3d Marine Raider Battaliom, Camp Lejeune, NC 28546 | 2018-06-04 |
| 1639661192 | Kenneth Lee Russell | Military Health Care Provider | 3d Marine Raider Battalion, Camp Lejeune, NC 28546 | 2018-05-31 |
| 1346730173 | Coastal Foot Center, LLC | Clinic/Center | 29 Office Park Dr Ste B, Jacksonville, NC 28546 | 2018-05-17 |
| 1578080271 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 380 Western Blvd, Jacksonville, NC 28546 | 2017-08-24 |
| 1144757493 | Darin Lee Peterson | Specialist/Technologist | G644 Camp Geiger, School of Infantry-east, Jacksonville, NC 28546 | 2017-05-17 |
| Find all providers in zip 28546 | ||||
| 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 |
|---|---|---|---|---|
| 1174045868 | Jonathan Rashad Habersham | Military Health Care Provider | 1255 Vandenberg Dr, Jacksonville, AR 72099-4942 | 2017-07-13 |
| 1679025795 | Claudia Irene Sloan | Military Health Care Provider | 1090 Arnold Dr, Jacksonville, AR 72099-4933 | 2016-10-25 |
| 1851703177 | Robert Murray Jr. | Military Health Care Provider | 2080 Child St, Jacksonville, FL 32214-5005 | 2014-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528415841 | Kelby Joseph Sage Durnin | Military Health Care Provider | 1020 Jabara Avenue, Seymour Johnson Afb, NC 27534 | 2016-05-17 |
| 1225425655 | Justin Wells | Military Health Care Provider | 1398 Surveyor St, Pope Army Airfield, NC 28308-2710 | 2015-04-23 |
| 1912267295 | Amber Lynn Scouton | Military Health Care Provider | 215 Bolling Dr, Goldsboro, NC 27534-5527 | 2012-05-21 |
| 1750662417 | Daryl Bradley | Military Health Care Provider | 146 Tulane Dr, Raeford, NC 28376 | 2011-09-07 |
| 1811211642 | Leasa C Novotny | Military Health Care Provider | 271 Sheridan Forest Rd Apt 1200, Goldsboro, NC 27534-7155 | 2010-03-23 |
| 1467784926 | James Blake Little | Military Health Care Provider | 300 Meadow Rd, Goldsboro, NC 27534-8759 | 2010-02-09 |
| 1710116595 | Patrick Joseph Hunt | Military Health Care Provider | 1 Matero Dr, Ol-c 342trs, Pope, NC 28308 | 2009-07-14 |
| 1184850760 | Jose Victor Nazario | Military Health Care Provider | 628 Ed Moye Rd, La Grange, NC 28551-8888 | 2009-06-09 |
| 1962637504 | Christopher Michael Lohr | Military Health Care Provider | 102 Partridge Rd, Fayetteville, NC 28306-8235 | 2009-05-27 |
| 1417191974 | Erik William Rodriguez | Military Health Care Provider | 106 Purple Martin Pl, Fayetteville, NC 28306-8262 | 2009-04-28 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE |
| Zip Code | 28546 |
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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.