DR. KEVIN DALE HETTINGER (NPI# 1356338065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356338065 |
| Entity Type | Individual |
| Full Name | DR. KEVIN DALE HETTINGER |
| Credential | M.D. |
| Practice Address |
18th Medical Group Unit 5142 Apo AP 96368 |
| Mailing Address |
Psc 80 Box 21839 Apo AP 96367-0103 |
| Practice Telephone | 3156305050 |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2020-11-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 01056228A | IN | Allopathic & Osteopathic Physicians |
| Y | 2083A0100X |
Preventive Medicine Specialization: Aerospace Medicine |
01056228A | IN | Allopathic & Osteopathic Physicians |
| N | 2083X0100X |
Preventive Medicine Specialization: Occupational Medicine |
01056228A | IN | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2510 5th St Bldg 840, Usafsam/feer, Wright Patterson Afb, OH 454337951 | 9379382744 | |
| Raf Lakenheath 48 Mdg/sghc, Unit 5115, Apo, AE 094615115 | 3142383831 |
| Street Address |
18TH MEDICAL GROUP UNIT 5142 |
| City | APO |
| State | AP |
| Zip Code | 96368 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013530203 | Jacqueline Marie Floyd | Nurse Practitioner | 18th Medical Group Unit 5142, Kadena Air Base, Apo, AP 96368 | 2020-05-21 |
| 1063943173 | Tiffany Chance | Nurse Practitioner | 18th Medical Group Unit 5142, Apo, AP 96368 | 2017-03-22 |
| 1295188308 | Matthew Vanderlugt | Physician Assistant | 18th Medical Group Unit 5142, Apo, AP 96368 | 2016-07-14 |
| 1720430051 | Amanda Johnson | Counselor | 18th Medical Group Unit 5142, Apo, AP 96368 | 2016-07-11 |
| 1982095915 | Kate M Berry | Nurse Practitioner | 18th Medical Group Unit 5142, Apo, AP 96368-5142 | 2015-02-12 |
| 1396159521 | Mack Andelin Peterson | Family Medicine | 18th Medical Group Unit 5142, Apo, AP 96368-5142 | 2014-06-16 |
| 1437599719 | Kasey Carl Welch | Family Medicine | 18th Medical Group Unit 5142, Apo, AP 96368 | 2013-07-01 |
| 1902245780 | Jonathon James Campbell | Student in an Organized Health Care Education/Training Program | 18th Medical Group Unit 5142, Apo, AP 96368 | 2013-06-14 |
| 1437405842 | Pablo R Rivera | Social Worker | 18th Medical Group Unit 5142, Apo, AP 96368 | 2012-08-03 |
| 1992064471 | Joshua Shields | Anesthesiology | 18th Medical Group Unit 5142, Apo, AP 96368-5142 | 2012-05-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063872703 | Halston Thayer | Dentist | 18th Medical Group. Unit 5142, Apo, AP 96368 | 2016-02-23 |
| 1912392333 | Jennifer Chilson | Military Health Care Provider | Bldg 3531 Unit 5247 B 10, Apo, AP 96368 | 2015-04-02 |
| 1811245962 | Greyson Leftwich | Dentist | 18th Medical Group, Bldg 626. Unit 5142, Apo, AP 96368 | 2012-08-21 |
| 1639440720 | Marta T Casbeer | Social Worker | Unit 4142, Apo, AP 96368 | 2012-01-20 |
| 1538454335 | Rachel Jeanty Asuquo | Internal Medicine | Kadena Air Base, Apo, AP 96368 | 2011-06-09 |
| 1730489451 | Laura Driver | Dentist | Kadena Afb 18 Mdg, Unit 5142, Apo, AP 96368 | 2010-10-28 |
| 1043442247 | Christina M Carter | Nurse Practitioner | 18th Med Group Unit 5142, Apo, AP 96368 | 2009-08-20 |
| 1659515070 | David J Billings | Military Health Care Provider | 353d Operations Support Squadron, Unit 5247 Box 10, Apo, AP 96368 | 2009-04-29 |
| 1427292226 | Melissa Anne Worley | Emergency Medical Technician, Paramedic | Bldg 3531, Kadena Ab Japan, Apo, AP 96368 | 2009-04-23 |
| 1922240571 | Richard H Caballero | Pharmacist | 18 Mdss Pharmacy, Unit 5268 Bld 626, Apo, AP 96368 | 2009-03-28 |
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| Taxonomy Code | 2083A0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Aerospace Medicine |
| Aerospace medicine focuses on the clinical care, research, and operational support of the health, safety, and performance of crewmembers and passengers of air and space vehicles, together with the support personnel who assist operation of such vehicles. This population often works and lives in remote, isolated, extreme, or enclosed environments under conditions of physical and psychological stress. Practitioners strive for an optimal human-machine match in occupational settings rich with environmental hazards and engineering countermeasures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326491903 | Nathan Hoi-king Kwan | Preventive Medicine | Usag Humphreys, Bldg. #3030, Unit #15245, Apo, AP 96271 | 2016-07-19 |
| 1336528363 | Talon Miner | Preventive Medicine | 86 Amds / Sgpf, Flight Surgeon Office Unit 3215, Apo, AE 09094 | 2015-05-22 |
| 1427440791 | Jonathan Christopher Banta | Preventive Medicine | 8 Mdg, Unit 2022, Apo, AP 96264-2022 | 2015-02-24 |
| 1578973921 | Joseph Lincoln Abrams | Preventive Medicine | 86 Amds Unit 3212, Apo, AE 09094 | 2014-05-06 |
| 1073572368 | Timothy D. Robinette | Preventive Medicine | 86th Mdg Unit 3215, Apo, AE 09094-3215 | 2006-03-23 |
| 1447248489 | Alan Benjamin Berg | Preventive Medicine | 379 Emdg/cc, Apo, AE 09309 | 2005-10-13 |
| 1275527228 | Christopher David Drew | Preventive Medicine | 435 Mdg, Unit 3215, Apo, AE 09094 | 2005-09-07 |
| 1932580388 | Teresa Lynn Micotto | Preventive Medicine | 18th Medical Group, Unit 5142, Apo, AP 96368-5142 | 2015-06-11 |
| 1174928865 | Jafet A Ojeda Rodriguez | Preventive Medicine | 18th Medical Group, Unit 5142, Apo, AP 96368 | 2014-10-24 |
| 1447313176 | Frederick Baird Harris | Preventive Medicine | Usameddac Wuerzburg, 12th Combat Aviation Brigade, Apo, AE 09250 | 2006-12-17 |
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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.