TERESA LYNN MICOTTO (NPI# 1932580388) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1932580388 |
Entity Type | Individual |
Full Name | TERESA LYNN MICOTTO |
Credential | M.D. |
Practice Address |
18th Medical Group, Unit 5142 Apo AP 96368-5142 |
Mailing Address |
Psc 80 Box 14088 Apo AP 96367-0043 |
Practice Telephone | 3156304780 |
Mailing Telephone | 3156304229 |
Enumeration Date | 2015-06-11 |
Last Update Date | 2018-08-02 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 2083A0100X |
Preventive Medicine Specialization: Aerospace Medicine |
29639 | NE | Allopathic & Osteopathic Physicians |
Y | 171000000X | Military Health Care Provider | 29639 | NE | Other Service Providers |
Street Address |
18TH MEDICAL GROUP, UNIT 5142 |
City | APO |
State | AP |
Zip Code | 96368-5142 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972784494 | Laura Marie Boylan | Social Worker | 18th Medical Group, Unit 5142, Apo, AP 96368-5142 | 2007-11-27 |
1225483621 | Ryan Mark | Family Medicine | 18th Medical Group, Unit 5142, Apo, AP 96368 | 2016-05-04 |
1952761702 | Jennifer Tanaka | Dentist | 18th Medical Group, Unit 5142, Apo, AP 96368-5142 | 2016-03-07 |
1124400478 | Lincoln Andreasen | Family Medicine | 18th Medical Group, Unit 5142, Apo, AP 96368-5142 | 2015-06-23 |
1174928865 | Jafet A Ojeda Rodriguez | Preventive Medicine | 18th Medical Group, Unit 5142, Apo, AP 96368 | 2014-10-24 |
1245639418 | Ivette Josefina Russo | Psychologist | 18th Medical Group, Unit 5142, Apo, AP 96368 | 2014-08-13 |
1487074274 | Jenny Wylie | Nurse Practitioner | 18th Medical Group, Unit 5142, Apo, AP 96368-5142 | 2014-04-21 |
1497187330 | Shannon Napua Hickman Roman | Social Worker | 18th Medical Group, Unit 5142, Apo, AP 96368-9998 | 2013-08-02 |
1215376207 | Yalonda Pone | Social Worker | 18th Medical Group, Unit 5142, Apo, AP 96368-5142 | 2013-06-23 |
1598008534 | Adam N Young | Internal Medicine | 18th Medical Group, Unit 5142, Apo, AP 96368-5142 | 2013-03-28 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063872703 | Halston Thayer | Dentist | 18th Medical Group. Unit 5142, Apo, AP 96368 | 2016-02-23 |
1912392333 | Jennifer Chilson | Military Health Care Provider | Bldg 3531 Unit 5247 B 10, Apo, AP 96368 | 2015-04-02 |
1811245962 | Greyson Leftwich | Dentist | 18th Medical Group, Bldg 626. Unit 5142, Apo, AP 96368 | 2012-08-21 |
1639440720 | Marta T Casbeer | Social Worker | Unit 4142, Apo, AP 96368 | 2012-01-20 |
1538454335 | Rachel Jeanty Asuquo | Internal Medicine | Kadena Air Base, Apo, AP 96368 | 2011-06-09 |
1730489451 | Laura Driver | Dentist | Kadena Afb 18 Mdg, Unit 5142, Apo, AP 96368 | 2010-10-28 |
1043442247 | Christina M Carter | Nurse Practitioner | 18th Med Group Unit 5142, Apo, AP 96368 | 2009-08-20 |
1659515070 | David J Billings | Military Health Care Provider | 353d Operations Support Squadron, Unit 5247 Box 10, Apo, AP 96368 | 2009-04-29 |
1427292226 | Melissa Anne Worley | Emergency Medical Technician, Paramedic | Bldg 3531, Kadena Ab Japan, Apo, AP 96368 | 2009-04-23 |
1922240571 | Richard H Caballero | Pharmacist | 18 Mdss Pharmacy, Unit 5268 Bld 626, Apo, AP 96368 | 2009-03-28 |
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Taxonomy Code | 171000000X |
Grouping | Other Service Providers |
Classification | Military Health Care Provider |
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
Notes: [7/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730700253 | Udaya Dahal | Military Health Care Provider | Grafenwoehr, De Tower Barracks, Usag-b, Apo, AE 09114 | 2020-05-06 |
1386273449 | Nicholas Thomas Nelson | Military Health Care Provider | 633d Medical Group, 76 Nealy Ave, Building #92, Apo, AA 23665 | 2020-04-02 |
1538795679 | Tanner Sean Harvey | Military Health Care Provider | 1mrb Bas, Apo, AA 92010 | 2020-03-20 |
1124686472 | Oscar Christian | Military Health Care Provider | Hospital: Wh3s9a 549 Hc/baach, Unit 15245, Apo, AP 96271 | 2019-06-02 |
1932687340 | Jennifer Marie Sisson | Military Health Care Provider | 4-2 Arb, Apo, AP 96271 | 2018-07-30 |
1962921049 | Heidi Grondahl | Military Health Care Provider | Building 2, Del Din Clinic, Apo, AE 09606 | 2017-09-11 |
1922546654 | Alexandria Fraleigh Jaksha | Military Health Care Provider | Blg 8740 Unit 23809, Cmr 405, Bx 52, Apo, AE 09034 | 2017-02-01 |
1447702154 | Jerry C Mallory Jr. | Military Health Care Provider | 4018 Bayard 44121, Apo, AA 44121 | 2016-10-28 |
1306226121 | Clinton Rebello | Military Health Care Provider | Mcguire Afb, Apo, AA 08610 | 2015-06-06 |
1255661005 | Thomas J Drummond | Military Health Care Provider | Hhc 3-4 Inf, Cmr 405 Box #5427, Apo, AE 09034 | 2009-12-29 |
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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.