LUKE WILLIAM WILLIS (NPI# 1588996243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588996243 |
| Entity Type | Individual |
| Full Name | LUKE WILLIAM WILLIS |
| Credential | IDMT |
| Practice Address |
1965 Shawnee Dr Colorado Springs CO 80915-1920 |
| Practice Telephone | 7193754057 |
| Enumeration Date | 2010-02-05 |
| Last Update Date | 2010-02-05 |
| 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 |
1965 SHAWNEE DR |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80915-1920 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073911418 | Verus Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 5050 Edison Ave, Suite 116, Colorado Springs, CO 80915 | 2014-12-17 |
| 1114202041 | Stateserv Medical of Colorado LLC | Durable Medical Equipment & Medical Supplies | 920 Ford St., Suite A, Colorado Springs, CO 80915 | 2011-10-11 |
| 1447550355 | Andrew Timothy Huwe | Pharmacist | 665 N Murray Blvd, Colorado Springs, CO 80915 | 2010-10-26 |
| 1891005013 | Community Services & Supports | Day Training, Developmentally Disabled Services | 4575 Galley Rd., Suite 400a, Colorado Springs, CO 80915 | 2010-10-21 |
| 1891022505 | South Powers Dental Prof LLC | Dentist | 1580 Space Center Drive, Suite 107, Colorado Springs, CO 80915 | 2009-11-17 |
| 1720212780 | Nicole Marie Malyj | Counselor | 1520 E. Owen Circle, Colorado Springs, CO 80915 | 2009-05-06 |
| 1134325848 | Catherine M Cortese | Audiologist | 1695 Leoti Drive, Colorado Springs, CO 80915 | 2007-06-21 |
| 1306965108 | Jeanie Bein | Psychologist | 4520 Brady Rd, Colorado Springs, CO 80915 | 2007-03-29 |
| 1982749909 | Clint L Kasza | Optometrist | Vision Center At Wal-mart, 1575 Space Center Drive, Colorado Springs, CO 80915 | 2007-02-20 |
| 1013063130 | Miriam Owens | Counselor | 1611 Sanderson Avenue, Colorado Springs, CO 80915 | 2007-01-25 |
| Find all providers in zip 80915 | ||||
| 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 |
|---|---|---|---|---|
| 1255754214 | Lynor Dicang Hardy | Military Health Care Provider | Cheyenne Mountain Air Station, Colorado Springs, CO 80922 | 2014-01-28 |
| 1912243239 | Lerinda Kay Carle | Military Health Care Provider | 6676 Myrtle Creek Dr, Colorado Springs, CO 80927-4034 | 2012-12-13 |
| 1851675011 | Susanne Clariece Fry | Military Health Care Provider | 2540 Brady Dr, Colorado Springs, CO 80917-4021 | 2011-10-06 |
| 1932342094 | Daniel Luther Green IIi | Military Health Care Provider | 1 Norad Rd, Colorado Springs, CO 80914-6001 | 2009-04-19 |
| 1316587116 | Cori Lea Andrews | Military Health Care Provider | 559 Vincent St Bldg 959, Colorado Springs, CO 80914-1541 | 2020-01-09 |
| 1700013380 | Curtis E Clawson | Military Health Care Provider | 1 Norad Rd, Suite 1205, Colorado Springs, CO 80906 | 2009-06-22 |
| 1740417641 | David Andrew Holman | Military Health Care Provider | 559 Vincent St, Colorado Springs, CO 80914-1541 | 2009-06-18 |
| 1386879633 | Edward L Nelson Jr. | Military Health Care Provider | 559 Vincent St, Colorado Springs, CO 80914-1541 | 2009-05-15 |
| 1831333996 | Mandy Grimm | Military Health Care Provider | 559 Vincent St, Colorado Springs, CO 80914-1541 | 2009-04-20 |
| 1386887792 | Jovonne D Parnell | Military Health Care Provider | 559 Vincent St, Colorado Springs, CO 80914-1541 | 2009-04-15 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80915 |
Please comment or provide details below to improve the information on LUKE WILLIAM WILLIS.
| 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.