MS. ALEXISA M HUMPHREY (NPI# 1891125001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891125001 |
| Entity Type | Individual |
| Full Name | MS. ALEXISA M HUMPHREY |
| Credential | IDMT |
| Practice Address |
225 Von Karman Rd Bldg 225 Arnold Afb TN 37389 |
| Mailing Address |
3241 Mitchell St Tullahoma TN 37388-4156 |
| Practice Telephone | 9314545365 |
| Mailing Telephone | 7024271782 |
| Enumeration Date | 2013-11-25 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| 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 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 77 Nealy Ave, Langley Afb, VA 236652040 | 7572252452 |
| Street Address |
225 VON KARMAN RD BLDG 225 |
| City | ARNOLD AFB |
| State | TN |
| Zip Code | 37389 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407090517 | Robert Louchery | Military Health Care Provider | 225 Von Karmon, First Street, Arnold Afb, TN 37389 | 2009-04-21 |
| 1427132422 | Patricia Suzanne Jackson | Family Medicine | 225 Von Karman Ave, Tullahoma Va Clinic, Arnold Afb, TN 37389 | 2006-10-25 |
| 1275632465 | 96th Medical Support Squadron Sgsl | Military/U.S. Coast Guard Pharmacy | 225 First St Bldg 225, Arnold Afb, TN 37389 | 2006-09-22 |
| 1982700878 | Tija L Mcdaniels | Family Medicine | 225 Von Karman Road, Arnold Air Force Base, TN 37389 | 2006-09-16 |
| 1659535557 | Charles Tessier Iv | Family Medicine | 225 First Ave, Apo, AA 37389-2401 | 2008-07-10 |
| 1649372970 | Cerisia A Cummings | Emergency Medicine | 225 First St, Arnold Air Force Base, TN 37389-2402 | 2006-09-05 |
| 1104837491 | Shawnya York Black | Nurse Practitioner | 225 Von Karmon Road, Arnold Air Force Base, TN 37389-2402 | 2006-08-11 |
| 1326082546 | Nashville Vamc | Clinic/Center | 225 Von Karman Road, Arnold Air Force Base, TN 37389-9998 | 2006-06-16 |
| 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 |
|---|---|---|---|---|
| 1407090517 | Robert Louchery | Military Health Care Provider | 225 Von Karmon, First Street, Arnold Afb, TN 37389 | 2009-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770854101 | Troy Edward Long | Military Health Care Provider | 8504 Emory Rd Ne, Corryton, TN 37721 | 2012-01-17 |
| 1225321433 | Zachary Marker | Military Health Care Provider | 114 Parham Rd, Martin, TN 38237-7137 | 2011-05-20 |
| 1932334463 | Christopher Kevin Mclain | Military Health Care Provider | 420 Post Ave, 134th Medical Aid Station, Mcghee Tyson Airbase, TN 37777-7602 | 2009-05-28 |
| 1558845362 | Walter Buckner | Military Health Care Provider | 420 Post Ave, Louisville, TN 37777-6223 | 2018-09-18 |
| 1104052216 | Jack Homer Atkins IIi | Military Health Care Provider | 420 Post Ave, Louisville, TN 37777-6223 | 2009-06-03 |
| 1811123128 | Glen Robert Riley | Military Health Care Provider | 420 Post Ave, Louisville, TN 37777-6223 | 2009-06-02 |
| 1669674818 | Mark David Narduzzi | Military Health Care Provider | 5722 Integrity Dr, Bldg S-771, Millington, TN 38054-5028 | 2007-06-01 |
| City | ARNOLD AFB |
| Zip Code | 37389 |
Please comment or provide details below to improve the information on MS. ALEXISA M HUMPHREY.
| 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.