MRS. LEESA M SMITH (NPI# 1013200757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1013200757 |
Entity Type | Individual |
Full Name | MRS. LEESA M SMITH |
Credential | IDMT |
Practice Address |
10447b Longmire Rd Fort Lewis WA 98433 |
Mailing Address |
10447b Longmire Rd Joint Base Lewis Mcchord WA 98433-1357 |
Practice Telephone | 2539703244 |
Mailing Telephone | 2539703244 |
Enumeration Date | 2011-05-26 |
Last Update Date | 2011-05-26 |
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 |
TX | Other Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801368873 | Leesa Clark Smith | Technician | 416 Bristle Cone Ln, Naples, FL 34113-8308 | 2019-01-01 |
1811199276 | Leesa Lanelle Smith | Counselor | 13851 Oak Haven Dr, Moss Point, MS 39562-9165 | 2007-06-05 |
1629179791 | Leesa Hogg Smith | Optometrist | 1607 Highway 1 S, Greenville, MS 38701-7832 | 2006-09-25 |
Street Address |
10447B LONGMIRE RD |
City | FORT LEWIS |
State | WA |
Zip Code | 98433 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134739881 | Bryonna Floyd | Dental Assistant | 11572 17th & C Street, Joint Base Lewis-mcchord, WA 98433 | 2020-08-07 |
1790393213 | Matthew T Ellison | Dentist | Dental Clinic 2, 3740 South 14th St., Joint Base Lewis-mcchord, WA 98433 | 2020-07-21 |
1952933251 | Julie Kristen Dutler | Dental Hygienist | 11572 C St, Jblm, WA 98433 | 2020-02-05 |
1881224806 | James Eric Carvelli | Dental Assistant | 11572 17th Street & C Street, Joint Base Lewis Mcchord, WA 98433 | 2020-01-17 |
1245891019 | Tanya Latrell Lesane | Counselor | 9924b W. Johnson St, Joint Base Lewis0mcchord, WA 98433 | 2019-06-24 |
1740844224 | Allison Tracy Bertoni | Student in an Organized Health Care Education/Training Program | 3740 South 14th Street, Joint Base Lewis-mcchord, WA 98433 | 2019-04-30 |
1124682448 | Lori Ann Sage | Registered Nurse | Building 11582, 17th & C Street, Joint Base Lewis-mcchord, WA 98433 | 2019-04-23 |
1639645997 | Emily Elisabeth Armstrong | Emergency Medical Technician, Paramedic | 3370 Evergreen Ave, Jblm, WA 98433 | 2018-10-15 |
1982182101 | Won Kyung Yang | Dentist | 11582 C St., Jblm, WA 98433 | 2018-07-31 |
1205325966 | Gloria Judith Penate I | Dental Hygienist | 2103 North Division Street, Tacoma, WA 98433 | 2018-05-08 |
Find all providers in zip 98433 |
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 |
---|---|---|---|---|
1598232902 | Jozlinn Rae | Military Health Care Provider | 3710 N Garry Rd, Otis Orchards, WA 99027-9397 | 2018-10-24 |
1790236503 | Mark Friskel | Military Health Care Provider | 5759a Fort Wright Oval, Fairchild Afb, WA 99011-2203 | 2016-10-17 |
1356682702 | Stacie Michelle Hoeger | Military Health Care Provider | 7505 N Wall St, Spokane, WA 99208-6104 | 2013-03-11 |
1730317728 | Nicholas James Graham | Military Health Care Provider | 2504 S.chicago St, Fairchild Afb, WA 99011 | 2009-06-29 |
1922232099 | Pocco S Bussey | Military Health Care Provider | 92 Medical Group, Flight Medicine Clinic, Fairchild, WA 99011 | 2009-05-05 |
1699919696 | Jason Stone Weiss | Military Health Care Provider | 3222 E 35th Ave, Spokane, WA 99223-4125 | 2009-04-22 |
1083783336 | Ronald Merel Husman | Military Health Care Provider | Uss Ford Ffg 54, Attn Medical Department, Fpo Ap, WA 96665-1508 | 2006-11-08 |
1053370254 | Erica Clarkson | Military Health Care Provider | Madigan Physical Therapy, Tacoma, WA 98431-0001 | 2006-03-17 |
1982175113 | Miguel Antonio Rodriguez Jr. | Military Health Care Provider | 690 Barnes Blvd, Joint Base Lewis Mcchord, WA 98438-1303 | 2018-12-16 |
1730691148 | Bryce Ferland | Military Health Care Provider | 701 Hospital Loop, Fairchild Afb, WA 99011-8704 | 2017-10-26 |
Find all providers with the same taxonomy |
City | FORT LEWIS |
Zip Code | 98433 |
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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.