MICHEAL A BENAMON (NPI# 1972749554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972749554 |
| Entity Type | Individual |
| Full Name | MICHEAL A BENAMON |
| Practice Address |
301 Andrews Avenue Lyster Army Health Clinic Fort Rucker AL 36362-5333 |
| Practice Telephone | 3342557169 |
| Practice Fax Number | 3342557173 |
| Mailing Telephone | 3342557169 |
| Mailing Fax Number | 3342557173 |
| Enumeration Date | 2009-01-02 |
| Last Update Date | 2009-01-02 |
| 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 |
| Street Address |
301 ANDREWS AVENUE LYSTER ARMY HEALTH CLINIC |
| City | FORT RUCKER |
| State | AL |
| Zip Code | 36362-5333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932107307 | James C. Dover | Optometrist | 301 Andrews Avenue, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2005-07-11 |
| 1598376469 | Wesley Hendrick Mccormick | Psychologist | 301 Andrews Avenue, Fort Rucker, AL 36362 | 2020-08-13 |
| 1366936817 | Twanna Versel Johnson | Social Worker | 301 Andrews Avenue, Cavhcs (va Wiregrass Clinic), Fort Rucker, AL 36362 | 2018-06-19 |
| 1770096406 | Jose A Morejon | Emergency Medical Technician, Basic | 301 Andrews Avenue, Fort Rucker, AL 36362 | 2017-11-16 |
| 1013446723 | Christopher Warren Fleming | Pharmacist | 301 Andrews Avenue, Fort Rucker, AL 36362 | 2017-06-06 |
| 1497296701 | Cody Shedd | Emergency Medical Technician, Basic | 301 Andrews Avenue, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2017-03-20 |
| 1760924583 | James Darren Beasley | Physical Therapy Assistant | 301 Andrews Avenue, Fort Rucker, AL 36360 | 2016-11-10 |
| 1538616768 | Deseree Moe | Emergency Medical Technician, Basic | 301 Andrews Avenue, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2016-09-06 |
| 1093261232 | Kristin Henderson | Registered Nurse | 301 Andrews Avenue, Fort Rucker, AL 36362 | 2016-08-28 |
| 1942652490 | Evie Ehret | Occupational Therapist | 301 Andrews Avenue, Fort Rucker, AL 36362 | 2016-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235745571 | Rachel Kestler | Specialist | 4102 Gadiator Street, Fort Rucker, AL 36362 | 2020-09-22 |
| 1417589268 | Jacob Michael Lezon | Emergency Medical Technician, Basic | 30501 Nevins St., Ft. Rucker, AL 36362 | 2020-02-10 |
| 1225535388 | Rhonda Lewis Wesolek | Dental Hygienist | Bldg 4405, Innkeeper Street, Fort Rucker, AL 36362 | 2018-04-06 |
| 1770013369 | National Vision, Inc. | Technician/Technologist | Bldg 9214, Fort Rucker, AL 36362 | 2017-06-15 |
| 1750730958 | Teresa Morgan Knighten | Dental Hygienist | 4405 Innkeepers St, Fort Rucker, AL 36362 | 2016-06-08 |
| 1568826246 | David Virgil II | Technician, Other | 2218 6th Avenue Building 4102, Fort Rucker, AL 36362 | 2016-04-08 |
| 1356771257 | Robert E Smith | Emergency Medical Technician, Intermediate | Blding 301 Andrew Ave, Ft Rucker, AL 36362 | 2013-11-14 |
| 1548503469 | Lindsey Taylor Mendenhall | Emergency Medical Technician, Basic | Bldg 301 Andrews Ave 1-223rd Hhc, Lyster Army Health Clinic, Fort Rucker, AL 36362 | 2013-03-28 |
| 1689913808 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | Fort Rucker Bldg. 9214, Daleville, AL 36362 | 2013-02-07 |
| 1275880205 | Sandra Lynn Griffin Banner | Optometrist | 33 Endl Ave, Fort Rucker, AL 36362 | 2012-08-09 |
| Find all providers in zip 36362 | ||||
| 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 |
|---|---|---|---|---|
| 1295913820 | Joseph Russel Brown | Military Health Care Provider | Bld 315 Usaamc, Fort Rucker, AL 36362 | 2008-02-06 |
| 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 |
| 1912223249 | Kenena Danielle Johnson | Military Health Care Provider | 3711 Pecan Grove Dr Nw, Huntsville, AL 35810-2639 | 2010-04-12 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | FORT RUCKER |
| Zip Code | 36362 |
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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.