MR. TRAVIS J FRITZ (NPI# 1730491176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730491176 |
| Entity Type | Individual |
| Full Name | MR. TRAVIS J FRITZ |
| Credential | IDMT |
| Practice Address |
712 Osceola Cir Eglin Afb FL 32542-1638 |
| Practice Telephone | 8505860155 |
| Mailing Telephone | 8505860155 |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2010-07-13 |
| 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 |
712 OSCEOLA CIR |
| City | EGLIN AFB |
| State | FL |
| Zip Code | 32542-1638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417440306 | Colt Sicher | Student in an Organized Health Care Education/Training Program | 96th Dental Squadron (afmc), Eglin Afb, Fl 32542, Apo, AA 32542 | 2018-06-14 |
| 1841679529 | Matthew Scurria | Dentist | 340 Boatner Rd. Bldg 2751, 96 Dental Squadron/sgdr, Eglin Afb, FL 32542 | 2015-05-27 |
| 1134518798 | 96th Medical Support Squadron | Military/U.S. Coast Guard Pharmacy | 3120 A. Talon Way, Eglin Afb Fld #3, FL 32542 | 2015-01-20 |
| 1598177123 | 96th Medical Support Squadron | Military/U.S. Coast Guard Pharmacy | 96 Medical Group Satellite Phcy Memorial Trail, Bldg. 1758, Eglin Afb, FL 32542 | 2014-06-02 |
| 1548602923 | Gerald Jordan Novack | Psychologist | 96mdos/sgow, 307 Boatner Rd, Fpo, AP 32542 | 2013-07-25 |
| 1699112821 | Taylor Anne Hahn | Obstetrics & Gynecology | 96th Medical Group, 307 Boatner Road, Eglin Air Force Base, FL 32542 | 2013-05-29 |
| 1730456948 | Nicholas Brandon Sager | Dentist | 340 Boatner Rd, Eglin Afb, Apo, AA 32542 | 2011-11-17 |
| 1134402662 | Jessamy Jae Thornton | Student in an Organized Health Care Education/Training Program | 340 Boatner Rd, Bldg 2751, Eglin Afb, FL 32542 | 2011-09-21 |
| 1346523974 | Mary Elizabeth Sorrentino | Dentist | 340 Boatner Road, Blgd. 2751, Eglin Afb, FL 32542 | 2011-09-20 |
| 1588945612 | Martin Army Community Hospital | Clinic/Center | 4327 North El Salvador Way, Eglin Afb, FL 32542 | 2011-09-02 |
| Find all providers in zip 32542 | ||||
| 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 |
|---|---|---|---|---|
| 1760625974 | Dexter Eli Vanderpool | Military Health Care Provider | 101 Griffin Way, Eglin Afb, FL 32542 | 2009-04-17 |
| 1366042178 | Whitney Nichole Eckstine | Military Health Care Provider | 340 Boatner Rd, Eglin Afb, FL 32542-1391 | 2020-10-30 |
| 1336774215 | Emanuel Leroy Lookadoo Jr. | Military Health Care Provider | 340 Boatner Rd, Eglin Afb, FL 32542-1391 | 2020-03-11 |
| 1669012555 | Jeremy Carmical | Military Health Care Provider | 340 Boatner Rd, Eglin Afb, FL 32542-1391 | 2020-01-09 |
| 1376186213 | Kayle Elizabeth Southerland | Military Health Care Provider | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2019-10-23 |
| 1033671227 | Stephen Thomas Biggs | Military Health Care Provider | 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 | 2019-04-05 |
| 1053870428 | Albert Roy Schliesleder Jr. | Military Health Care Provider | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2019-03-15 |
| 1245701473 | Marc Anthony Marrero | Military Health Care Provider | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2018-12-16 |
| 1053814236 | Kirsty Lynn House | Military Health Care Provider | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2018-03-14 |
| 1245756055 | James B Raper | Military Health Care Provider | 307 Boatner Rd, Eglin Afb, FL 32542-1302 | 2017-08-15 |
| Find all providers in EGLIN AFB | ||||
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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.