MR. LAKEDRIAN GUY (NPI# 1679828842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679828842 |
| Entity Type | Individual |
| Full Name | MR. LAKEDRIAN GUY |
| Credential | IDMT |
| Practice Address |
980 Courthouse Rd Apt 1521 Gulfport MS 39507-4298 |
| Practice Telephone | 8504507044 |
| Mailing Telephone | 8504507044 |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2012-07-13 |
| 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 |
980 COURTHOUSE RD APT 1521 |
| City | GULFPORT |
| State | MS |
| Zip Code | 39507-4298 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609389105 | Karen R Burns | Speech-Language Pathologist | 3506 Washington Avenue, Ste E, Gulfport, MS 39507 | 2017-11-07 |
| 1538605027 | Andrea Broussard | Personal Emergency Response Attendant | 406 Pass Rd, Gulfport, MS 39507 | 2017-01-09 |
| 1366872491 | William Alexis Marcia | Pharmacist | 1444 East Pass Road, Gulfport, MS 39507 | 2013-11-27 |
| 1740599380 | Advanced Hearing Systems, Inc. | Hearing Instrument Specialist | 401 Security Square, Gulfport, MS 39507 | 2010-09-30 |
| 1497068118 | Stacey Ritter Carter | Dentist | 1635 East Pass Road, Gulfport, MS 39507 | 2010-07-22 |
| 1477789964 | Letonoff Orthopaedics & Sports | Orthopaedic Surgery | 452 Court House Road, Suite G, Gulfport, MS 39507 | 2009-06-10 |
| 1730385139 | Bernard Frederick Podlin | Dentist | 400 Pass Road, Gulfport, MS 39507 | 2007-06-22 |
| 1043422553 | Mark D Stringer | Dentist | 520-a Courthouse Road, Gulfport, MS 39507 | 2007-05-04 |
| 1154543528 | Pass Road Elementary | Registered Nurse | 37 Pass Road, Gulfport, MS 39507 | 2007-05-03 |
| 1417073768 | John Hough Hopkins | Dentist | 3303 A Ave, Gulfport, MS 39507 | 2007-03-21 |
| Find all providers in zip 39507 | ||||
| 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 |
|---|---|---|---|---|
| 1699055616 | Ashley Elizabeth Gross | Military Health Care Provider | 605 Leigh Dr Apt F50, Columbus, MS 39705-3369 | 2011-08-22 |
| 1639472236 | Derrick Dewayne Sweat | Military Health Care Provider | 213 Mcnarney Dr, Biloxi, MS 39531-3191 | 2010-12-21 |
| 1306043641 | William Anthony Minor | Military Health Care Provider | 2603 Lower Gainsville Rd, Nattc Sbt 22, Ssc, MS 39529 | 2007-06-29 |
| 1811098361 | Alvin Watson | Military Health Care Provider | 630 Columbia St, Hattiesburg, MS 39401-2801 | 2006-09-26 |
| 1861099913 | Enrique I Padron | Military Health Care Provider | 301 Fisher St, Biloxi, MS 39534-2508 | 2020-10-01 |
| 1881229623 | Jesse Recarte | Military Health Care Provider | 301 Fisher St, Biloxi, MS 39534-2508 | 2020-03-11 |
| 1356994362 | Zsane Wrice | Military Health Care Provider | 301 Fisher St, Biloxi, MS 39534-2508 | 2019-07-18 |
| 1336608702 | Alexa Duesler | Military Health Care Provider | 500 Fisher St, Biloxi, MS 39534-2502 | 2019-03-15 |
| 1992190425 | Seth Haas | Military Health Care Provider | 301 Fisher St, Biloxi, MS 39534-2508 | 2015-04-01 |
| 1073943288 | Anna Martin | Military Health Care Provider | 301 Fisher St, Keesler Afb, MS 39534-2508 | 2013-11-25 |
| Find all providers with the same taxonomy | ||||
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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.