JOHN LA CRUZ


Address: 22 Mdg, Mcconnell Afb, KS 67221-3712
Phone: 3167595116

JOHN LA CRUZ (NPI# 1760616015) 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) 1760616015
Entity Type Individual
Full Name JOHN LA CRUZ
Credential IDMT
Practice Address 22 Mdg
Mcconnell Afb
KS 67221-3712
Practice Telephone 3167595116
Mailing Telephone 3167595116
Enumeration Date 2009-05-14
Last Update Date 2009-05-14
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

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1619528254 John Paul Cruz Student in an Organized Health Care Education/Training Program 2008 N Garey Ave, Pomona, CA 91767-2722 2019-09-25
1104332170 John J Cruz Peer Specialist 65 N Keller, Republic, WA 99166-8804 2017-12-28
1881086668 John William Cruz Emergency Medicine 1120 15th St, Augusta, GA 30912-1000 2015-03-03
1427457092 John Cruz Counselor 386 W Main St, Bergenfield, NJ 07621-1569 2014-08-19
1922326495 John Michael Cruz Psychiatry & Neurology 2001 Dwight Way, Suite 4190, Berkeley, CA 94704-2608 2010-05-09
1609047091 John Junior Cruz Physician Assistant 4212 N 16th St, Phoenix, AZ 85016-5319 2008-03-13

Office Location

Street Address 22 MDG
City MCCONNELL AFB
State KS
Zip Code 67221-3712

Providers in the same location

NPI Name Taxonomy Address Enumeration
1750371456 Larry E Chupp Physician Assistant 22 Mdg, 57950 Leavenworth St, Mcconnell Afb, KS 67221-3506 2005-10-24
1922232271 Richard Jimenez Rubi Military Health Care Provider 22 Mdg, Mcconnell Afb, KS 67221 2009-05-14
1023071107 Daniel Robert Lamothe General Practice 22 Mdg, 57950 Leavenworth St, Mcconnell Afb, KS 67221-3506 2006-04-10

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1922528421 Rose Lee Samples Nurse Practitioner 51950 Leavenworth St., Family Health Clinic 22 Mdg, Mcconnell Afb, KS 67221 2017-06-26
1114247913 Dawn Marie Clifton Nurse Practitioner 57950 Leavenworth Ave Bldg 250, 22d Medical Group, Mcconnell Afb, KS 67221 2010-06-03
1467514489 22nd Medical Group Pharmacy 57590 Leavenworth Bldg 250, Mcconnell Afb, KS 67221 2006-12-15
1336182153 National Vision, Inc. Eyewear Supplier (Equipment, not the service) Derby Street, Building 352, Mcconnell Afb, KS 67221 2006-06-13
1578919049 Kathryn Rachel Kocher Pediatrics 57950 Leavenworth St, Mcconnell Afb, KS 67221 2016-05-13
1962707067 Melissa M Wendt Physician Assistant 57950 Leavenworth St Ste 4e1, Mcconnell Afb, KS 67221 2011-01-20
1871581306 Joshua A Hartman Emergency Medicine 57950 Leavenworth St Bldg 248, Mcconnell Afb, KS 67221-3505 2005-10-10
1184242604 Lindsey Allison Cunningham Dentist 57950 Leavenworth St, Wichita, KS 67221-3505 2020-07-10
1164052700 Taylor Holloway Family Medicine 57950 Leavenworth St Bldg 250, Mcconnell Afb, KS 67221-3505 2020-01-23
1407296940 Daniel Richard Galle Optometrist 57950 Leavenworth St Ste 4e1, Mcconnell Afb, KS 67221-3505 2013-06-28
Find all providers in zip 67221

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
1255569612 Janice Renee Faught Military Health Care Provider 57950 Leavenworth St Bldg 250, Mcconnell Afb, KS 67221-3506 2009-06-24
1083264550 Brianna Hope Slayback Military Health Care Provider 57950 Leavenworth St, Mcconnell Afb, KS 67221-3506 2019-09-17
1295212413 Walter Steven Agudelo Military Health Care Provider 57950 Leavenworth St, Mcconnell Afb, KS 67221-3506 2018-07-20
1215425657 Jordon L Jeans Military Health Care Provider 57950 Leavenworth St, Mcconnell Afb, KS 67221-3506 2018-05-01
1568960342 Justine R Froude Military Health Care Provider 57950 Leavenworth St, Mcconnell Afb, KS 67221-3506 2018-01-26
1992190318 David Clauson Military Health Care Provider 57950 Leavenworth St, Mcconnell Afb, KS 67221-3506 2015-04-02
1669873394 Douglas Livingston IIi Military Health Care Provider 57950 Leavenworth St, Mcconnell Afb, KS 67221-3506 2014-09-12
1740613397 Brooke Elizabeth Prine Military Health Care Provider 57950 Leavenworth St, Mcconnell Afb, KS 67221-3506 2013-08-19
1922232271 Richard Jimenez Rubi Military Health Care Provider 22 Mdg, Mcconnell Afb, KS 67221 2009-05-14

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1184968505 Bobbi Jean Harrington Military Health Care Provider 2504 W Manhattan Dr, Wichita, KS 67204-5426 2012-11-26
1972800514 Derick Lee Tibbetts Military Health Care Provider 638 S Whittier St, Wichita, KS 67207-2222 2011-02-17
1396048906 Colby P Shinkle Military Health Care Provider 2176 S Pinecrest St, Wichita, KS 67218-5234 2010-12-21

Competitor

Search similar providers

City MCCONNELL AFB
Zip Code 67221

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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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