BRANDON JOHN POTTERS


Address: Air Test and Evaluation Squadron Nine Rd 187 Rd, Edwards Afb, CA 93524-0001
Phone: 6618601540

BRANDON JOHN POTTERS (NPI# 1245751460) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1245751460
Entity Type Individual
Full Name BRANDON JOHN POTTERS
Credential IDC
Practice Address Air Test and Evaluation Squadron Nine Rd 187 Rd
Edwards Afb
CA 93524-0001
Mailing Address Air Test and Evaluation Squadron Nine Rd
187 North Flightline Road
Edwards Afb
CA 93524-0001
Practice Telephone 6618601540
Enumeration Date 2017-06-28
Last Update Date 2017-06-28
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1710I1002X Military Health Care Provider
Specialization: Independent Duty Corpsman
Other Service Providers

Office Location

Street Address AIR TEST AND EVALUATION SQUADRON NINE RD 187 RD
City EDWARDS AFB
State CA
Zip Code 93524-0001

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1114540499 Nathaniel George Brown Student in an Organized Health Care Education/Training Program 412th Medical Group 30 Nightingale Rd., Building #5525, Edwards Air Force Base, CA 93524 2020-05-21
1265852396 Wesley John Fischer Pharmacist 30 Nightengale Road, Edwards U.S. Air Force Base Pharmacy, Edwards, CA 93524 2014-04-16
1659567493 Kevin Ray Hooker Social Worker 30 Nightingale Road, 5513, Lancaster, CA 93524 2007-09-14
1336655943 Keith Janda Physician Assistant 95th Medical Group 30 Nightingale Road Building 5525, Edwards Afb, CA 93524-0001 2017-12-19
1598286049 Mackenzie Johnson Clevenger Pharmacist 412 Mdg 30 Nightingale Rd, Edwards Afb, CA 93524-0001 2017-07-05
1003266073 Meshva Akwalia Pediatrics 412 Medical Group 30 Nightingale Rd Bldg 5525, Edwards Afb, CA 93524-0001 2016-06-20
1144613670 Pang Ko Dentist 30 Nightingale Ave Building 5513, Edwards, CA 93524-0001 2015-03-09
1710293345 Tonya Nicole Barry Dentist Bldg 3925, 31 Nightingale Rd, Edwards Afb, CA 93524-0001 2010-08-20
1265761340 Shanda R. Marshall Nurse Practitioner 412 Th Medical Grouup, 30 Nightingale Road, Edwards, CA 93524-0001 2009-12-18
1639300197 Moises Velasco Military Health Care Provider 412 Th Medical Group, 30 Nightingale Rd., Edwards Afb, CA 93524-0001 2009-07-31
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Taxonomy Information

Taxonomy Code 1710I1002X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Corpsman

Taxonomy Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1316547227 Landri Acosta Military Health Care Provider 5075 Tranquil Way # 102, Oceanside, CA 92057-7870 2020-10-29
1649879537 David Michael Soliani Military Health Care Provider Bld 4101 Stuart Mesa Road, Camp Pendleton, CA 92055-5584 2020-10-21
1801494182 Luis Alberto Necoechea Military Health Care Provider 1st Recon Bn Bas, Oceanside, CA 92055 2020-10-09
1770180648 Darius Lee Sean Woods Military Health Care Provider 6033 Sandy Shore Ct, San Diego, CA 92139-1014 2020-10-05
1174130744 Daniel Carrera Military Health Care Provider 2645 W Canyon Ave Apt 450, San Diego, CA 92123-4700 2020-09-28
1316551740 Kyle Bode Francis Military Health Care Provider 3149 Murray Ridge Rd, San Diego, CA 92123-2917 2020-09-02
1356955918 Daniel Carr Military Health Care Provider 5423 Lake Murray Blvd Apt 7, La Mesa, CA 91942-1551 2020-09-01
1255945069 Jeremy Lee Military Health Care Provider 509 Dennery Rd Apt 145, San Diego, CA 92154-8542 2020-08-31
1639782899 Tyler Collin Sparks Military Health Care Provider 1 Mrb, Camp Pendletion, CA 92055 2020-08-27
1013520667 Rashaad Brown Military Health Care Provider 4454 Cherokee Ave Apt 2, San Diego, CA 92116-3611 2020-08-24
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Competitor

Search similar providers

City EDWARDS AFB
Zip Code 93524

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Dataset Information

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.

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