MR. JACK HOMER ATKINS III (NPI# 1104052216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104052216 |
| Entity Type | Individual |
| Full Name | MR. JACK HOMER ATKINS III |
| Credential | IDMT |
| Practice Address |
420 Post Ave Louisville TN 37777-6223 |
| Practice Telephone | 8659854277 |
| Practice Fax Number | 8659854273 |
| Mailing Telephone | 8659854277 |
| Mailing Fax Number | 8659854273 |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2009-06-03 |
| 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 |
|---|---|---|---|---|
| 1083812580 | Jack H Atkins | Dentist | 13 Birdseye Cir, Wayne, NJ 07470-4944 | 2007-07-05 |
| Street Address |
420 POST AVE |
| City | LOUISVILLE |
| State | TN |
| Zip Code | 37777-6223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558845362 | Walter Buckner | Military Health Care Provider | 420 Post Ave, Louisville, TN 37777-6223 | 2018-09-18 |
| 1811123128 | Glen Robert Riley | Military Health Care Provider | 420 Post Ave, Louisville, TN 37777-6223 | 2009-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225405475 | Blount County Snf Operations, LLC | Skilled Nursing Facility | 1965 Stewart Lane, Louisville, TN 37777 | 2015-08-24 |
| 1932533643 | Mary Martin Cadieux | Obstetrics & Gynecology | 3824 Compass Pointe Dr, Louisville, TN 37777 | 2013-08-29 |
| 1386960102 | Toni Danielle Pickle | Social Worker | 2431 Jones Bend Rd., Louisville, TN 37777 | 2010-04-19 |
| 1255666590 | Dale William Willetts | Specialist/Technologist, Other | 3733 Riverbrook Dr, Louisville, TN 37777 | 2009-10-05 |
| 1598998619 | Village Behavioral Health, LLC | Psychiatric Residential Treatment Facility | 2431 Jones Bend Road, Louisville, TN 37777 | 2009-08-25 |
| 1538364716 | East Tennessee Children's Hospital Primary Care Center, Inc. | Clinic/Center | 1921 Topside Road, Louisville, TN 37777 | 2007-06-18 |
| 1245392760 | Barbara L Taylor | Psychologist | 2341 Jones Bend Road, Louisville, TN 37777 | 2006-12-14 |
| 1427132786 | Parkwest Medical Center | Residential Treatment Facility, Emotionally Disturbed Children | 2341 Jones Bend Rd, Louisville, TN 37777 | 2006-10-24 |
| 1811960834 | Barrington N Nash | Family Medicine | 1921 Topside Rd, Ste 200, Louisville, TN 37777 | 2006-02-09 |
| 1871580027 | Kci Usa, Inc. | Durable Medical Equipment & Medical Supplies | 1705 Base Pointe Way, Louisville, TN 37777 | 2005-10-03 |
| Find all providers in zip 37777 | ||||
| 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 |
|---|---|---|---|---|
| 1518313089 | Mark Wilson | Military Health Care Provider | 1101 Grade Ln, 123 Special Tactics, Louisville, KY 40213-2673 | 2016-05-13 |
| 1497001044 | Paul K Vought | Military Health Care Provider | 9223 Rainbow Springs Ct Apt 5, Louisville, KY 40241-2249 | 2012-08-01 |
| 1558845362 | Walter Buckner | Military Health Care Provider | 420 Post Ave, Louisville, TN 37777-6223 | 2018-09-18 |
| 1811123128 | Glen Robert Riley | Military Health Care Provider | 420 Post Ave, Louisville, TN 37777-6223 | 2009-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891125001 | Alexisa M Humphrey | Military Health Care Provider | 225 Von Karman Rd, Bldg 225, Arnold Afb, TN 37389 | 2013-11-25 |
| 1770854101 | Troy Edward Long | Military Health Care Provider | 8504 Emory Rd Ne, Corryton, TN 37721 | 2012-01-17 |
| 1225321433 | Zachary Marker | Military Health Care Provider | 114 Parham Rd, Martin, TN 38237-7137 | 2011-05-20 |
| 1932334463 | Christopher Kevin Mclain | Military Health Care Provider | 420 Post Ave, 134th Medical Aid Station, Mcghee Tyson Airbase, TN 37777-7602 | 2009-05-28 |
| 1407090517 | Robert Louchery | Military Health Care Provider | 225 Von Karmon, First Street, Arnold Afb, TN 37389 | 2009-04-21 |
| 1669674818 | Mark David Narduzzi | Military Health Care Provider | 5722 Integrity Dr, Bldg S-771, Millington, TN 38054-5028 | 2007-06-01 |
| City | LOUISVILLE |
| Zip Code | 37777 |
Please comment or provide details below to improve the information on MR. JACK HOMER ATKINS III.
| 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.