MR. DAVID LAYNE FREDERICK JR. (NPI# 1821334244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821334244 |
| Entity Type | Individual |
| Full Name | MR. DAVID LAYNE FREDERICK JR. |
| Credential | IDMT |
| Practice Address |
1050 Jabarrah Ave Seymour Johnson A F B NC 27531-2310 |
| Mailing Address |
405 Woodhille Dr Goldsboro NC 27530-9066 |
| Practice Telephone | 9197221522 |
| Mailing Telephone | 9196488310 |
| Enumeration Date | 2012-12-13 |
| Last Update Date | 2012-12-13 |
| 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 |
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|---|---|---|---|---|
| 1275943987 | David Frederick | Naturopath | 1815 E Georgia Ave, Phoenix, AZ 85016-3313 | 2014-05-02 |
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| 1205824893 | David Eugene Frederick | Psychologist | 1218 5th Ave, Huntington, WV 25701-2234 | 2005-10-09 |
| 1306371364 | David Frederick | Psychologist | 2340 Eastern Blvd, York, PA 17402-2897 | 2017-04-27 |
| 1669820296 | David Grant Frederick | Psychiatry & Neurology | Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114 | 2016-05-24 |
| 1053748103 | David Lawrence Frederick | Pharmacist | 3741 Highway 14, Millbrook, AL 36054-1905 | 2013-10-03 |
| 1104189026 | David Frederick | Internal Medicine | 919 E 32nd St, Austin, TX 78705-2703 | 2012-06-18 |
| 1215035662 | David E Frederick | Counselor | 230 Park St, Wautoma, WI 54982-9031 | 2006-09-20 |
| Street Address |
1050 JABARRAH AVE |
| City | SEYMOUR JOHNSON A F B |
| State | NC |
| Zip Code | 27531-2310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053316562 | Stephen Brian Irvin | Family Medicine | 1050 Jabarrah Ave, Seymour Johnson A F B, NC 27531-2310 | 2005-06-21 |
| 1952704975 | Andrea Sumner | Physician Assistant | 1050 Jabarrah Ave, Seymour Johnson A F B, NC 27531-2310 | 2014-10-04 |
| 1962774356 | Logan A Latimer | Military Health Care Provider | 1050 Jabarrah Ave, Flight Medicine Clinic, Seymour Johnson A F B, NC 27531-2310 | 2012-02-01 |
| 1285918342 | Tiffany Moore Brassard | Dietitian, Registered | 1050 Jabarrah Ave, Seymour Johnson A F B, NC 27531-2310 | 2011-10-06 |
| 1023306438 | Jennifer Thomas | Registered Nurse | 1050 Jabarrah Ave, Seymour Johnson A F B, NC 27531-2310 | 2011-07-19 |
| 1386937027 | Christopher Gary Keeton | Military Health Care Provider | 1050 Jabarrah Ave, Seymour Johnson A F B, NC 27531-2310 | 2011-05-26 |
| 1659501476 | Andrea M Rope | Optometrist | 1050 Jabarrah Ave, 4amds/sgge Attn: Optometry Clinic, Seymour Johnson A F B, NC 27531-2310 | 2009-07-15 |
| 1184867442 | Angela Marie Carter | Military Health Care Provider | 1050 Jabarrah Ave, Seymour Johnson A F B, NC 27531-2310 | 2009-04-15 |
| 1255319232 | Shannon Susan Hill | Nurse Practitioner | 1050 Jabarrah Ave, 4th Medical Group, Seymour Johnson A F B, NC 27531-2310 | 2006-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376185348 | Adam Golos | Pharmacist | 2803 Medical, N Campus Dr, Goldsboro, NC 27531 | 2019-10-11 |
| 1346747011 | Rachel Eden Leigh Palmer | Military Health Care Provider | 2803 Medical Campus Dr, Seymour Johnson Afb, NC 27531 | 2018-04-10 |
| 1689108508 | Peri Fouss | Pediatrics | 2803 Medical Campus Drive, Goldsboro, NC 27531 | 2017-04-18 |
| 1700256427 | Karen Schaefer | Psychologist | 1050 Jabara Ave., Goldsboro, NC 27531 | 2015-10-07 |
| 1679059737 | Charles Billig | Physician Assistant | 2803 Medical Campus Dr, Goldsboro, NC 27531 | 2018-07-12 |
| 1710413216 | Michael Everett Ridlehoover | Dentist | 2803 Medical Campus Drive, Seymour Johnson Afb, NC 27531 | 2017-05-04 |
| 1679924344 | Austin Mcjunkins | Surgery | 1050 Jabara Ave, Seymour Johnson A F B, NC 27531 | 2016-06-23 |
| 1033596937 | Christina Marie Pyeatt | Military Health Care Provider | 1050 Jabara Ave, Flight Medicine Clinic, Seymour Johnson Afb, NC 27531 | 2015-04-29 |
| 1790931723 | Joshua S Swantek | Pharmacist | 1050 Jabara Ave, Seymour Johnson Afb, Goldsboro, NC 27531 | 2008-08-11 |
| 1750430435 | Brooke Wenman Heroux | Psychologist | 1050 Jabara Ave, Goldsboro, NC 27531 | 2007-01-10 |
| Find all providers in zip 27531 | ||||
| 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 |
|---|---|---|---|---|
| 1902343858 | Isaiah Gary Allison | Military Health Care Provider | 1050 Jabara Ave, Seymour Johnson A F B, NC 27531-2310 | 2017-01-30 |
| 1962774356 | Logan A Latimer | Military Health Care Provider | 1050 Jabarrah Ave, Flight Medicine Clinic, Seymour Johnson A F B, NC 27531-2310 | 2012-02-01 |
| 1386937027 | Christopher Gary Keeton | Military Health Care Provider | 1050 Jabarrah Ave, Seymour Johnson A F B, NC 27531-2310 | 2011-05-26 |
| 1184867442 | Angela Marie Carter | Military Health Care Provider | 1050 Jabarrah Ave, Seymour Johnson A F B, NC 27531-2310 | 2009-04-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528415841 | Kelby Joseph Sage Durnin | Military Health Care Provider | 1020 Jabara Avenue, Seymour Johnson Afb, NC 27534 | 2016-05-17 |
| 1225425655 | Justin Wells | Military Health Care Provider | 1398 Surveyor St, Pope Army Airfield, NC 28308-2710 | 2015-04-23 |
| 1912267295 | Amber Lynn Scouton | Military Health Care Provider | 215 Bolling Dr, Goldsboro, NC 27534-5527 | 2012-05-21 |
| 1750662417 | Daryl Bradley | Military Health Care Provider | 146 Tulane Dr, Raeford, NC 28376 | 2011-09-07 |
| 1811211642 | Leasa C Novotny | Military Health Care Provider | 271 Sheridan Forest Rd Apt 1200, Goldsboro, NC 27534-7155 | 2010-03-23 |
| 1467784926 | James Blake Little | Military Health Care Provider | 300 Meadow Rd, Goldsboro, NC 27534-8759 | 2010-02-09 |
| 1710116595 | Patrick Joseph Hunt | Military Health Care Provider | 1 Matero Dr, Ol-c 342trs, Pope, NC 28308 | 2009-07-14 |
| 1184850760 | Jose Victor Nazario | Military Health Care Provider | 628 Ed Moye Rd, La Grange, NC 28551-8888 | 2009-06-09 |
| 1962637504 | Christopher Michael Lohr | Military Health Care Provider | 102 Partridge Rd, Fayetteville, NC 28306-8235 | 2009-05-27 |
| 1417191974 | Erik William Rodriguez | Military Health Care Provider | 106 Purple Martin Pl, Fayetteville, NC 28306-8262 | 2009-04-28 |
| Find all providers with the same taxonomy | ||||
| City | SEYMOUR JOHNSON A F B |
| Zip Code | 27531 |
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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.