KODY WHITESIDE


Address: 99 Friendship Bldv, Apo, AP 96319-0061
Phone: 3152266647

KODY WHITESIDE (NPI# 1689060311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1689060311
Entity Type Individual
Full Name KODY WHITESIDE
Practice Address 99 Friendship Bldv
Apo
AP 96319-0061
Mailing Address Psc 76 Box 6072
Apo
AP 96319-0061
Practice Telephone 3152266647
Enumeration Date 2015-04-09
Last Update Date 2015-04-09
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1710I1003X Military Health Care Provider
Specialization: Independent Duty Medical Technicians
Other Service Providers

Office Location

Street Address 99 FRIENDSHIP BLDV
City APO
State AP
Zip Code 96319-0061

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NPI Name Taxonomy Address Enumeration
1518510528 Jeffrey Alan Utz Military Health Care Provider 35 Mdg Misawa, Misawa, AOMORI 96319 2019-07-18
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1619101870 John Michael Cronin Military Health Care Provider 35 Mdg, Misawa Ab, Japan, Apo, AP 96319 2009-05-04
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1427265701 Sharon H Proctor Marriage & Family Therapist Psc 76 Box 3974, Apo, AP 96319 2007-05-17
1073619656 Laura Jean Ryan Social Worker Unit 5024, Apo, AP 96319 2006-09-15
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Taxonomy Information

Taxonomy Code 1710I1003X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Medical Technicians

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1174166656 Samuel Mow Military Health Care Provider Landshul Regional Medical Center, Apo, AE 09180 2019-10-28
1881245967 Grant M Golombeski Military Health Care Provider 300 S Twinning Dr., Apo, AA 36112 2019-09-20
1346711579 Jimbell Gray Military Health Care Provider Building #932, Apo, AE 09464 2018-12-16
1942784442 Christopher Allen Foster Military Health Care Provider 18th Medical Group, Bldg 626, Unit 5142, Apo, AP 96368-5142 2018-09-20
1497294359 Ryan Springer Military Health Care Provider Psc 41 Box 2116, Apo, AE 09464-0022 2017-02-13
1205387081 Joshua Gratz Military Health Care Provider 48mdh/sghc Unit 5115, Apo, AE 09461 2016-10-17
1316322506 Andrew Bowers Military Health Care Provider Psc 2, Box 8707, Apo, AE 09012 2015-07-29
1912392333 Jennifer Chilson Military Health Care Provider Bldg 3531 Unit 5247 B 10, Apo, AP 96368 2015-04-02
1720409675 Emily Porter Military Health Care Provider Psc 17 Box 66, Apo, AE 09214-0001 2013-12-19
1134562507 Christopher Paul Soergel Military Health Care Provider Mobile Diving and Salvage Unit One, Building 17 Bishop Point, Apo, AE 96660-7005 2013-04-16
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City APO
Zip Code 96319

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Dataset Information

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.

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