MR. MICHAEL JAMES ANDERSON (NPI# 1982846416) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982846416 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL JAMES ANDERSON |
| Credential | IDMT |
| Practice Address |
110 Luke Ave Afmsa/sg3p Bolling Afb DC 20032 |
| Practice Telephone | 2027674340 |
| Practice Fax Number | 2027675302 |
| Mailing Telephone | 2027674340 |
| Mailing Fax Number | 2027675302 |
| Enumeration Date | 2009-03-30 |
| Last Update Date | 2009-03-30 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598374712 | Michael Richard Anderson | Clinic/Center | 2560 Hubbell Ave, Des Moines, IA 50317-6102 | 2020-07-23 |
| 1881234623 | Michael Anderson | Durable Medical Equipment & Medical Supplies | 1203 N Hobart St Ste 34, Pampa, TX 79065-4664 | 2020-01-09 |
| 1164920898 | Michael Anderson | Counselor | 502 Mccarty Ln Ste 5, Jackson, OH 45640-7025 | 2018-01-29 |
| 1609324789 | Michael Anderson | Counselor | 75 Heaton Dr, Covington, GA 30016-0224 | 2016-09-16 |
| 1629438437 | Michael Anderson | Counselor | 145 Yonker Street, Barbeton, OH 44203 | 2016-03-07 |
| 1124406186 | Michael A Anderson | Family Medicine | 1000 Pocatello Creek Rd Ste E10, Pocatello, ID 83201-2953 | 2015-05-11 |
| 1679971683 | Michael Anderson | Occupational Therapist | 355 Saddlebrook Cir, Lewisville, NC 27023-8213 | 2014-12-08 |
| 1881004877 | Michael Anderson | Anesthesiology | 2345 E Thomas Rd Ste 400, Phoenix, AZ 85016 | 2014-04-30 |
| 1467871517 | Michael Callum Anderson | Counselor | 1881 Ne 26th St Ste 70, Wilton Manors, FL 33305-1425 | 2014-04-15 |
| 1871911958 | Michael Anderson | Physical Therapist | 9909 Mira Mesa Blvd Ste 260, San Diego, CA 92131-1064 | 2014-04-04 |
| Street Address |
110 LUKE AVE AFMSA/SG3P |
| City | BOLLING AFB |
| State | DC |
| Zip Code | 20032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265594394 | Mary Ellen Hansen | Pharmacist | 110 Luke Ave, Bolling Afb, MD 20032 | 2006-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336753714 | Ebonie Hawkins | Counselor | 101 Xenia St Suite 200 Sw, Washington, DC 20032 | 2020-09-03 |
| 1639788938 | Richard Quinones | Technician | 4346 Livingston Rd Se, B, Washington, DC 20032 | 2020-07-23 |
| 1720603244 | Ankur Sah Swarnakar | Student in an Organized Health Care Education/Training Program | 1100 Alabama Ave Southeast, 2nd Floor, Suite 238, Washington, DC 20032 | 2020-06-10 |
| 1225659519 | Michael Thomas Moore | Counselor | 920 Belview St. Se, Washington, DC 20032 | 2020-04-28 |
| 1144878240 | Erika Kirkpatrick | Behavior Technician | 1218 Southern Ave Apt304 Se, Washgton Dc, DC 20032 | 2019-08-31 |
| 1982251351 | Agazit Asihel | Counselor | Friendship Charter School 645 Milwaukee Pl, Washington Dc, DC 20032 | 2019-08-21 |
| 1538715412 | Omonike Grace Adeosun | Home Health Aide | 2625 Martin Luther King Jr Ave Se, Apt 1, Washington, DC 20032 | 2019-08-15 |
| 1932753571 | Nadesh Mengwi Muluh | Home Health Aide | 2759 Martin Luther King Jr Avenue, Washington, DC 20032 | 2019-08-01 |
| 1376100115 | Kelsey Hobart | Student in an Organized Health Care Education/Training Program | Dc Dbh Seh Psych Residency 1100 Alabama Avenue, Se, Suite 238, Washington, DC 20032 | 2019-05-28 |
| 1407321417 | Abigail Christine Burke | Physical Therapist | 3146 Arnold Avenue Sw, Washington, DC 20032 | 2018-10-05 |
| Find all providers in zip 20032 | ||||
| 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 |
|---|---|---|---|---|
| 1437393618 | Edwardson A Aquino | Military Health Care Provider | 5497 Langley Way Sw Unit B, Bolling Afb, DC 20032-7670 | 2009-05-01 |
| 1760944953 | Torrian Tatum | Military Health Care Provider | 238 Brookley Ave Sw Bldg 1300, Bolling Afb, DC 20032-7704 | 2019-04-05 |
| 1467785790 | David Brian Sowers | Military Health Care Provider | 238 Brookley Ave, Bolling Afb, DC 20032 | 2009-09-18 |
| 1023245560 | Chad Michael Smith | Military Health Care Provider | 238 Brookley Ave, Bolling Afb, DC 20032 | 2009-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689107351 | Donise Wiggins | Military Health Care Provider | 2234 S St Se Apt 1, Washington, DC 20020-4503 | 2017-04-09 |
| 1164522280 | Mark Magrino | Military Health Care Provider | Cg-1122 Uscg Hq Comdt, 2100 2nd St Sw, Washington, DC 20593-0001 | 2006-09-25 |
| City | BOLLING AFB |
| Zip Code | 20032 |
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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.