MATTHEW PHILIP SCULLY


Address: 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529
Phone: 6167170169

MATTHEW PHILIP SCULLY (NPI# 1013256536) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1013256536
Entity Type Individual
Full Name MATTHEW PHILIP SCULLY
Credential IDMT
Practice Address 4881 Sugar Maple Dr
Wright Patterson Afb
OH 45433-5529
Mailing Address 4061 Cloud Park Dr
Aprt B-2
Huber Heights
OH 45424-8084
Practice Telephone 6167170169
Mailing Telephone 6167170169
Enumeration Date 2013-02-04
Last Update Date 2013-02-04
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1710I1003X Military Health Care Provider
Specialization: Independent Duty Medical Technicians
Other Service Providers

Office Location

Street Address 4881 SUGAR MAPLE DR
City WRIGHT PATTERSON AFB
State OH
Zip Code 45433-5529

Providers in the same location

NPI Name Taxonomy Address Enumeration
1104442813 Michael Anthony Salerno Military Health Care Provider 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 2020-06-18
1780209957 Stacey O'donnell Nurse Anesthetist, Certified Registered 4881 Sugar Maple Dr, 88mdg/sgcj, Wright Patterson Afb, OH 45433 2020-06-12
1043834328 William Woodfin Crosby Nurse Practitioner 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 2020-06-03
1447872833 Dayton Vamc Clinic/Center 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 2020-05-08
1629697750 Firas Zako Dentist 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 2020-04-09
1235768540 Jacob David Harley Dentist 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 2020-04-07
1326696527 Rebecca Noel Seagraves Pharmacist 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 2019-08-30
1154974095 Lori Saturley Dental Hygienist 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 2019-07-19
1902463987 Stephen Seth Childers Dentist 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 2019-05-24
1306409479 Sean Roberts Dentist 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 2019-04-15
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1891289518 Sara Lyons Physician Assistant 88 Mdj/sghj, 4881 Sugar Maple Dr, Wright-patterson Afb, OH 45433 2018-06-16
1073001558 Mega Margapuram Student in an Organized Health Care Education/Training Program 1 Sugar Maple Drive, Dayton, OH 45433 2018-04-30
1437667979 Michael Peter Dring Social Worker Building 830, Credentials Office, 4881 Sugar Maple Rd, Wpafb, OH 45433 2018-01-18
1316486814 Josiah Hardin Internal Medicine 88 Mdos/sgomi, 4881 Sugar Maple Dr., Wright-patterson Afb, OH 45433 2017-02-16
1780137380 Allison Osterfeld Pharmacist 88 Mdg 4881 Suga Maple Dr, Wright Patterson Afb, OH 45433 2016-07-29
1891144283 Kyle Harris Student in an Organized Health Care Education/Training Program 4481 Sugar Maple Dr., Wright Patterson Afb, OH 45433 2016-06-07
1245601756 Nichole Griep Audiologist 88 Mdg/sgpq, 4881 Sugar Maple Dr, Wright-patterson Afb, OH 45433 2015-10-09
1487021267 Melanie Schaffer Dietitian, Registered 4881 Sugamaple Drive, Wpafb, OH 45433 2015-08-27
1831582261 Joseph K Wray General Practice 88 Mdg/sgcj, 4881 Sugar Maple Dr., Wright-patterson Afb, OH 45433 2015-03-10
1659798031 Maninder Kaur Nurse Practitioner 88 Mdos/sgom, 4881 Sugar Maple Drive, Wright Patterson Afb, OH 45433 2014-03-24
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Taxonomy Information

Taxonomy Code 1710I1003X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Medical Technicians

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1104442813 Michael Anthony Salerno Military Health Care Provider 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 2020-06-18
1861954059 Bryan Thomas Courtney Military Health Care Provider 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 2019-04-05
1558714428 Rodney Bosserman Military Health Care Provider 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 2016-07-15
1215395561 Cassidy Lee Mccurdy Military Health Care Provider 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 2016-02-02
1740664044 Addison Gregory Stemmer Military Health Care Provider 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 2015-07-16
1538396809 Paul Richard Mccracken Military Health Care Provider 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5546 2009-06-15
1962638759 Charity E Green Military Health Care Provider 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5546 2009-06-08

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1992305700 Jason Patrick Scoles Military Health Care Provider 5607 Hickam Dr, Dayton, OH 45431-1544 2020-10-30
1497380364 Sean Francis Costello Military Health Care Provider 4884 Sugar Maple Dr, Wpafb, OH 45433-5533 2020-03-11
1902449846 Brandi Krueger-dunn Military Health Care Provider 4206 Redfern Rd, Parma, OH 44134-3364 2019-10-23
1821500232 Jacob Tyler Weaver Military Health Care Provider 7320 Canterbury Ct, Liberty Township, OH 45044-9227 2017-10-26
1538585682 Brian Milner Military Health Care Provider 9910 Sherwood Dr, Cincinnati, OH 45231-2526 2014-03-13
1184063729 Jasom Robert Kidnocker Military Health Care Provider 37 Rookwood Dr, Chillicothe, OH 45601-3085 2013-06-17
1629312988 Jack Williams Military Health Care Provider 116 Dickman Dr, Dayton, OH 45431-1570 2012-11-26
1760726178 Christy Wade Military Health Care Provider 19404 Harl Weiller Rd, Caldwell, OH 43724-9149 2012-11-26
1962775890 Nicole Marie Palko Military Health Care Provider 1104 Middy Dr, Dayton, OH 45433-1322 2012-02-23
1326339334 Brian J Kemp Military Health Care Provider 5823 Gross Dr, Dayton, OH 45431-1515 2011-04-25
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Competitor

Search similar providers

City WRIGHT PATTERSON AFB
Zip Code 45433

Improve Information

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Dataset Information

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.

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