JUSTIN CHIASSON (NPI# 1629436977) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629436977 |
| Entity Type | Individual |
| Full Name | JUSTIN CHIASSON |
| Credential | IDMT |
| Practice Address |
4175 S Alamo Ave Bldg 400 Davis Monthan Afb AZ 85707-4402 |
| Practice Telephone | 6267158203 |
| Mailing Telephone | 6267158203 |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2016-02-02 |
| 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 |
4175 S ALAMO AVE BLDG 400 |
| City | DAVIS MONTHAN AFB |
| State | AZ |
| Zip Code | 85707-4402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255430823 | John Patrick Moran | Family Medicine | 4175 S Alamo Ave Bldg 400, 355 Medical Group, Davis Monthan Afb, AZ 85707-6097 | 2006-09-21 |
| 1477893485 | Derek Snare | Dentist | 4175 S Alamo Ave Bldg 400, Davis Monthan Afb, AZ 85707-4402 | 2013-02-28 |
| 1871754358 | John Allis | Orthopaedic Surgery | 4175 S Alamo Ave Bldg 400, Davis Monthan Afb, AZ 85707-4402 | 2008-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699128850 | Megan Dehaven | Specialist/Technologist | 5455 E Comanche St, Tucson, AZ 85707 | 2016-07-22 |
| 1780927954 | Ryan N Taylor | Physician Assistant | 400, 4175 S Alamo Ave, Davis-monthan Afb, AZ 85707 | 2013-04-05 |
| 1154658839 | Alisha A Marchetti | Physician Assistant | 4175 S. Alamo Avenue, 355th Mdg/mdos, Davis-monthan Afb, AZ 85707 | 2009-11-17 |
| 1851529192 | Christopher Thomas Yarbrough | Military Health Care Provider | 4625 South Phoenix Street Bldg 4843, Tucson, AZ 85707 | 2009-06-25 |
| 1144457045 | Denise Fabian | Psychiatry & Neurology | 5427 E. Madera Street, Davis Monthan Afb, AZ 85707 | 2009-06-17 |
| 1942437447 | Emerson M Earle | Military Health Care Provider | 4625 S. Phoenix St, Bld 4843, Tucson, AZ 85707 | 2009-06-11 |
| 1164657136 | Raul Romero | Military Health Care Provider | 4575 S. Phoenix St. 563rd Oss, Dmafb, AZ 85707 | 2009-05-20 |
| 1063647196 | Virginia E. Bailey | Military Health Care Provider | 4837 S Phoenix St., Rm 119 Davis-monthan Air Force Base, Tucson, AZ 85707 | 2009-05-19 |
| 1043417611 | Jacob Riis | Orthopaedic Surgery | 355 Mdg, 4175 South Alamo Ave, Tucson, AZ 85707 | 2007-06-28 |
| 1508989732 | Christopher E. Dunham | Physician Assistant | 4175 S. Alamo Ave Bldg 400, 355th Medical Group-davis Monthan Afb, Tucson, AZ 85707 | 2007-04-10 |
| Find all providers in zip 85707 | ||||
| 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 |
|---|---|---|---|---|
| 1235433756 | Esmat Marie Sabbagh | Military Health Care Provider | 5020 E Arizola St, Davis Monthan Afb, AZ 85707-3108 | 2010-12-23 |
| 1306076377 | Jayme L Cline | Military Health Care Provider | 4175 S Alamo Ave, Davis Monthan Afb, AZ 85707-4402 | 2009-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225657828 | Casey Mulcahy | Military Health Care Provider | 2748 N 60th St, Scottsdale, AZ 85257-1012 | 2020-04-13 |
| 1194375667 | Nathan Andrew Lawson | Military Health Care Provider | 2336 E Libra Pl, Chandler, AZ 85249-3790 | 2019-09-17 |
| 1043787450 | Dustin Alford | Military Health Care Provider | 4280 E Burnsey Ln, Kingman, AZ 86401-5595 | 2018-10-24 |
| 1306259171 | Aaron Alvarez | Military Health Care Provider | 18026 W Carol Ave, Waddell, AZ 85355-4127 | 2014-06-09 |
| 1891118774 | Vianca Mendoza | Military Health Care Provider | 17714 W Desert Ln, Surprise, AZ 85388-1714 | 2014-01-28 |
| 1831449180 | Ronald John Borgstrom II | Military Health Care Provider | 15053 W Mulberry Dr, Goodyear, AZ 85395-8846 | 2012-09-13 |
| 1821358102 | Ngu Quang Do | Military Health Care Provider | 407 Campbell St, Prescott, AZ 86301-2518 | 2012-05-21 |
| 1053617464 | Bradley William Snyder | Military Health Care Provider | 7224 North 139th Avenue, Glendale, AZ 85309 | 2011-02-02 |
| 1043516610 | Charles Delvon Pickett | Military Health Care Provider | 7019 N Litchfield Ave, Luke Afb, 56/amds, Luke Afb, AZ 85309 | 2011-01-31 |
| 1417267949 | Humberto Alcocer | Military Health Care Provider | 4159 W 3rd Pl, Yuma, AZ 85364-1009 | 2010-10-18 |
| Find all providers with the same taxonomy | ||||
| City | DAVIS MONTHAN AFB |
| Zip Code | 85707 |
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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.