KENENA DANIELLE JOHNSON (NPI# 1912223249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912223249 |
| Entity Type | Individual |
| Full Name | KENENA DANIELLE JOHNSON |
| Credential | IDMT |
| Practice Address |
3711 Pecan Grove Dr Nw Huntsville AL 35810-2639 |
| Practice Telephone | 3255186917 |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2010-04-12 |
| 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 |
| Street Address |
3711 PECAN GROVE DR NW |
| City | HUNTSVILLE |
| State | AL |
| Zip Code | 35810-2639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821632928 | Janice Marie Scott | Technician | 3611 Grizzard Rd, Huntville, AL 35810 | 2019-10-31 |
| 1285094888 | Restore Therapy Services, Ltd | Occupational Therapist | 2061 Poole Drive, Huntsville, AL 35810 | 2016-02-25 |
| 1932442290 | Angela Lynell Miller | Specialist | 3228 Suite D Lodge Rd, Huntsville, AL 35810 | 2013-04-04 |
| 1376795104 | Amy Kathryn Scott | Occupational Therapist | 2061 Poole Drive Nw, Huntsville, AL 35810 | 2008-10-10 |
| 1306968565 | Mary Ann Mcdonald | Nurse Practitioner | 410 Sivley Rd Sw, Huntsville, AL 35810 | 2007-04-06 |
| 1801934815 | Great Expressions Dental Care | Dentist | 5045 North Memorial Parkway, Ste D, Hunstville, AL 35810 | 2007-02-02 |
| 1912004185 | Anthony Toney | Dentist | 2585 Sparkman Dr, Huntsville, AL 35810 | 2006-09-20 |
| 1710998349 | North Rimm Pharmacy LLC | Pharmacy | 5045 N Memorial Pkwy, Ste A, Huntsville, AL 35810 | 2006-08-10 |
| 1659855088 | Ashley Marie Patel | Occupational Therapist | 2061 Poole Drive, Huntsville, AL 35810 | 2018-09-21 |
| 1003309584 | Pamela L Cook | Occupational Therapist | 2061 Poole Drive, Huntsville, AL 35810 | 2018-06-11 |
| Find all providers in zip 35810 | ||||
| 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 |
|---|---|---|---|---|
| 1255801049 | Jose Edwin Aviles | Military Health Care Provider | Kelly Street, Montgomery, AL 36112 | 2018-12-05 |
| 1780956177 | Rolando Smythe | Military Health Care Provider | 91 White Ave, Maxwell Afb, AL 36113-6301 | 2012-02-01 |
| 1881991420 | James Henry Barnett Jr. | Military Health Care Provider | 1819 Shade Ave, Florence, AL 35630-2237 | 2011-02-17 |
| 1790095222 | Brad David Nunley | Military Health Care Provider | 1339 Spring Valley Dr Ne, Arab, AL 35016-5427 | 2010-10-18 |
| 1962714303 | Randylle E Sneed | Military Health Care Provider | 6254 Taylor Ridge Rd, Montgomery, AL 36116-6509 | 2010-07-13 |
| 1295979730 | Darrell Edward Kirby | Military Health Care Provider | 124 Chennault Circle, Montgomery, AL 36112 | 2009-04-28 |
| 1558505669 | Billy Houston Nored | Military Health Care Provider | 125 Chennault Cir, Montgomery, AL 36112-6008 | 2009-04-21 |
| 1396988705 | Mark K Thomas | Military Health Care Provider | 501 Lemay Plz N, Maxwell Afb, AL 36112-6025 | 2009-04-15 |
| 1962676791 | Stephanie Christine Mock | Military Health Care Provider | 8501 Tanner Wms Rd, Mobile, AL 36608-8322 | 2008-04-14 |
| 1295913820 | Joseph Russel Brown | Military Health Care Provider | Bld 315 Usaamc, Fort Rucker, AL 36362 | 2008-02-06 |
| Find all providers with the same taxonomy | ||||
| City | HUNTSVILLE |
| Zip Code | 35810 |
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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.