EDWARD BRENT LENNON (NPI# 1366492969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366492969 |
| Entity Type | Individual |
| Full Name | EDWARD BRENT LENNON |
| Credential | USN IDC |
| Practice Address |
100 Brewster Blvd Camp Lejeune NC 28547-2538 |
| Mailing Address |
1141 Lakeview Ave Richlands NC 28574-8235 |
| Practice Telephone | 9104511053 |
| Mailing Telephone | 9103241324 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2017-03-23 |
| 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 |
100 BREWSTER BLVD |
| City | CAMP LEJEUNE |
| State | NC |
| Zip Code | 28547-2538 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588668982 | Pierce Overman | Family Medicine | 100 Brewster Blvd, Naval Hospital, Camp Lejeune, NC 28547-2538 | 2005-06-13 |
| 1275146417 | Kristi Lynn Dixon | Nurse Practitioner | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-08-27 |
| 1841802253 | Konstance Mackie | Nurse Practitioner | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-08-18 |
| 1003425117 | Jeremy Moore | Licensed Practical Nurse | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-07-24 |
| 1801404546 | Erika Merite Papenfuss | Nurse Anesthetist, Certified Registered | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-07-20 |
| 1306454244 | Devon Nicole Dan | Nurse Anesthetist, Certified Registered | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-07-16 |
| 1851918957 | Uriah Nmn Paul | Nurse Anesthetist, Certified Registered | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-07-06 |
| 1447876529 | Leslee Lynne Smith | Speech-Language Pathologist | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-06-24 |
| 1356965727 | Haleigh Leister | Specialist/Technologist | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-06-02 |
| 1407482045 | Shajaylyn Lee-combs | Student in an Organized Health Care Education/Training Program | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-03-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558906032 | Abigail Deemer | Physician Assistant | L Street, Bldg Hp-416, Camp Lejeune, NC 28547 | 2019-11-08 |
| 1407406267 | Michelle Ferricher | Nurse Practitioner | Naval Medical Center Pediatric Clinic, Nh-200 Recovery Way, Camp Lejeune, NC 28547 | 2019-09-13 |
| 1215595566 | Kayla L Torrez Chang | General Practice | Mcmh Fc 308, Hm Smith Boulevard, Camp Lejeune, NC 28547 | 2019-06-02 |
| 1699338442 | Amanda Leigh Jepsen | Military Health Care Provider | Naval Medical Center; 100 Brewster Blvd, Camp Lejeune, NC 28547 | 2019-04-17 |
| 1306336995 | Erik Reid King | Physician Assistant | F Street Bldg. Hp206, Camp Lejeune, NC 28547 | 2018-05-18 |
| 1114434032 | David John Mcdermott | Specialist/Technologist | Bldg. H1 Julian C Smith Rd., Camp Lejuene, NC 28547 | 2017-12-30 |
| 1235678434 | Nicolle Elizabeth Johnson | Occupational Therapist | 180 Hospital Corps Blvd., Camp Lejeune, NC 28547 | 2017-02-21 |
| 1427435585 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | Stone St. Extention, Bldg Nh200, Camp Lejeune, NC 28547 | 2015-04-28 |
| 1043634173 | Garrett Michael Wren | Obstetrics & Gynecology | Naval Medical Center, 100 Brewster Blvd, Camp Lejeune, NC 28547 | 2014-02-10 |
| 1245662436 | Samuel Maluil | Internal Medicine | Bldg 124 Wallace Creek, Camp Lejeunce, NC 28547 | 2013-07-30 |
| Find all providers in zip 28547 | ||||
| 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 |
|---|---|---|---|---|
| 1205472693 | Kevin Edward Murphy | Military Health Care Provider | Rr612 Everett Creek Road, Camp Lejeune, NC 28542-0073 | 2019-11-21 |
| 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 | CAMP LEJEUNE |
| Zip Code | 28547 |
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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.