JON PAUL FITZGERALD (NPI# 1225526668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225526668 |
| Entity Type | Individual |
| Full Name | JON PAUL FITZGERALD |
| Credential | IDMT |
| Practice Address |
221 3rd St W Randolph Afb TX 78150-4800 |
| Practice Telephone | 2106521818 |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2018-05-01 |
| 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 |
221 3RD ST W |
| City | RANDOLPH AFB |
| State | TX |
| Zip Code | 78150-4800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780228015 | Garrett R Lyman | Physician Assistant | 221 3rd St W, Randolph Afb, TX 78150-4800 | 2019-10-30 |
| 1972074102 | Alexander Louis Nestor | Military Health Care Provider | 221 3rd St W, Randolph Afb, TX 78150-4800 | 2018-12-16 |
| 1861973349 | Kimberli M Molina | Physician Assistant | 221 3rd St W, Randolph Afb, TX 78150-4800 | 2018-08-23 |
| 1326587494 | Jonathan Madden | Military Health Care Provider | 221 3rd St W, Randolph Afb, TX 78150 | 2017-02-22 |
| 1508308685 | Stephanie Jean Campos | Registered Nurse | 221 3rd St W, Randolph Afb, TX 78150 | 2016-11-07 |
| 1568915643 | Shanna Leah Irizarry-miller | Nurse Practitioner | 221 3rd St W, Randolph Afb, TX 78150 | 2016-07-26 |
| 1215396072 | Kelly L. Riegleman | General Practice | 221 3rd St W, Randolph Afb, TX 78150-4800 | 2016-02-22 |
| 1982086807 | David Brockbank | Dentist | 221 3rd St W, Randolph Afb, TX 78150 | 2015-06-27 |
| 1528488558 | Maxwell Dickey | Preventive Medicine | 221 3rd St W, Randolph Afb, TX 78150-4800 | 2014-04-17 |
| 1740619923 | Michael Prater | Pharmacist | 221 3rd St W, Bldg 1040 Rm 1d201, Randolph Afb, TX 78150-4800 | 2013-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770045833 | Erica Renae Guevara | Physician Assistant | 559 Medial Sq, 221 Third Street West Bldg. 1040, Jbsa-randolph Afb, TX 78150 | 2019-04-05 |
| 1457803868 | Emily Newman | Dietitian, Registered | 221 Third Street West, Bldg. 999 Ste 2, Joint Base San Antonio -randolph, TX 78150 | 2016-11-02 |
| 1922411677 | Amber Drewer | Military Health Care Provider | 3rd Street West Building 1040, Randolph Afb, TX 78150 | 2014-06-10 |
| 1144652975 | Josephine Kimberly Olsen | Family Medicine | 359 Mdos/mdg, Randolph Afb, TX 78150 | 2013-08-02 |
| 1609149681 | Lucky Lusterio | Preventive Medicine | 221 3rd St. W, Randolph Afb, TX 78150 | 2012-02-21 |
| 1417120569 | Joni Hodgson | General Practice | 221 3rd Street West, Jbsa Randolph, TX 78150 | 2008-04-09 |
| 1710095724 | Katherine Justen Adamson | Physician Assistant | 12th Medical Group, 221 3rd Street West, Randolph Air Force Base, TX 78150 | 2006-08-29 |
| 1811950090 | Lidia Stana Ilcus | Internal Medicine | 359 Mdg, 221 Third Street West, Randolph Afb, TX 78150 | 2006-04-10 |
| 1013970672 | David Hamilton | Social Worker | 12mdos/sgohf, Randolph Afb, TX 78150 | 2006-04-06 |
| 1962465526 | Robert Allan Briggs | Physical Therapist | Randolph Afb Clinic, 221 3rd St W, Randolph Afb, TX 78150 | 2006-04-06 |
| Find all providers in zip 78150 | ||||
| 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 |
|---|---|---|---|---|
| 1922411677 | Amber Drewer | Military Health Care Provider | 3rd Street West Building 1040, Randolph Afb, TX 78150 | 2014-06-10 |
| 1972074102 | Alexander Louis Nestor | Military Health Care Provider | 221 3rd St W, Randolph Afb, TX 78150-4800 | 2018-12-16 |
| 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 | RANDOLPH AFB |
| Zip Code | 78150 |
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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.