PATRICK JAMES SCOLLON (NPI# 1134748692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134748692 |
| Entity Type | Individual |
| Full Name | PATRICK JAMES SCOLLON |
| Practice Address |
104 W D. L. Ingram Ave, Cannon Afb, Nm 88101 Cannon Afb NM 88101 |
| Mailing Address |
104 W D. L. Ingram Ave Cannon Afb NM 88101 |
| Practice Telephone | 5757842778 |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-04-14 |
| 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 |
104 W D. L. INGRAM AVE, CANNON AFB, NM 88101 |
| City | CANNON AFB |
| State | NM |
| Zip Code | 88101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285274878 | Keishla Cota | Physical Therapist | 100 East Manana Blvd, Unit 1, Clovis, NM 88101 | 2020-01-10 |
| 1659927283 | Ndeye Ndour | Nurse Anesthetist, Certified Registered | 2100 N M.l.k. Jr Blvd, Clovis, NM 88101 | 2019-08-09 |
| 1679132468 | Justine Nicole Nunez | Nurse Practitioner | 2301 North Doctor Martin Luther King Boulevard, Clovis, NM 88101 | 2019-06-06 |
| 1518453521 | Moore Psychological Services, Pllc | Social Worker | 1908 West 21st Street, Clovis, NM 88101 | 2018-07-03 |
| 1912494006 | Raesha Russell | Behavior Technician | 214 West 9th St, Clovis, NM 88101 | 2018-04-16 |
| 1013425800 | Vanessa Yardley | Registered Nurse | 2100 N. Martin Luther King Jr. Blvd., Clovis, NM 88101 | 2018-01-16 |
| 1699204230 | Olivia Garcia | Technician, Other | 1100 W 21st Street, Clovis, NM 88101 | 2017-06-07 |
| 1578006250 | Mary Ellen Gray | Technician, Other | 9408 B Vermont Court, Clovis, NM 88101 | 2016-11-29 |
| 1205296977 | Malaney Harmon | Behavioral Analyst | 2700 E 7th St., Clovis, NM 88101 | 2016-02-24 |
| 1114395811 | Megan Hall | Counselor | 2700 East 7th St, Clovis, NM 88101 | 2015-09-11 |
| Find all providers in zip 88101 | ||||
| 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 |
|---|---|---|---|---|
| 1598909012 | Martin Oleen Jensen | Military Health Care Provider | 119 E Arcadia Ave Bldg 622, 27 Special Operations Support Sqdn/osm, Cannon Afb, NM 88103-5112 | 2009-04-28 |
| 1053554204 | Jillian Marie Beausoleil | Military Health Care Provider | 511 N Torch Blvd Rm 102b, Cannon Afb, NM 88103-5109 | 2009-04-16 |
| 1295093912 | Desiree Anderson | Military Health Care Provider | 208 W Casablanca Ave, Cannon Afb, NM 88103-5009 | 2012-05-01 |
| 1497067839 | Ray Leroy Schatz IIi | Military Health Care Provider | 511 N Torch Blvd, Cannon Afb, NM 88103-5109 | 2010-07-13 |
| 1083844054 | Lindsay Vincent | Military Health Care Provider | 208 W Casablanca Ave, 27 Somdg, Cannon Afb, NM 88103-5009 | 2009-07-23 |
| 1497999684 | Francisco S Deguzman | Military Health Care Provider | 208 W Casablanca Ave Bldg 1400, 27 Somdg - Osm, Cannon Afb, NM 88103-5009 | 2009-05-01 |
| 1639313125 | Andrew Springstead | Military Health Care Provider | 208 W Casablanca Ave, 27somdg, Cannon Afb, NM 88103-5009 | 2009-04-28 |
| 1366686842 | Steven Brandon Yates | Military Health Care Provider | 208 W Casablanca Ave, Cannon Afb, NM 88103-5009 | 2009-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496625 | Stephen Kreidler | Military Health Care Provider | 5453 Roosevelt Loop Ne, Rio Rancho, NM 87144-5218 | 2020-10-30 |
| 1144797556 | William Murphy Whittle | Military Health Care Provider | 2000 Hallum St, Clovis, NM 88101-8684 | 2018-10-24 |
| 1265983068 | Yurikoaokio Motomochi Livas | Military Health Care Provider | 209 Wilmington Cir, Clovis, NM 88101-9382 | 2016-10-18 |
| 1245614544 | Rowland Coyle | Military Health Care Provider | 701 Stephen Moody Rd, Albuquerque, NM 87117 | 2015-07-16 |
| 1972939585 | Eugene Navarro Tabita | Military Health Care Provider | 4050a Greenhouse Pl Se, Albuquerque, NM 87116-3008 | 2013-09-16 |
| 1043553217 | Amanda Colyer | Military Health Care Provider | 2050 2nd St Se # A, Albuquerque, NM 87117-5522 | 2013-04-05 |
| 1831438357 | John Frederick Rinaldi | Military Health Care Provider | 3500 Adenmore Ct, Apt C, Clovis, NM 88101 | 2013-02-04 |
| 1003176389 | Ricky Franco Vela | Military Health Care Provider | 8101a W Sandia Cir Se, Albuquerque, NM 87116-5501 | 2012-05-21 |
| 1740583350 | Norma P Grandberry | Military Health Care Provider | 1501 Westchester St, Clovis, NM 88101-4638 | 2010-12-21 |
| 1609186139 | Jeramy Byrd | Military Health Care Provider | 9410 A Vermont Court, Clovis, NM 88101 | 2010-10-18 |
| Find all providers with the same taxonomy | ||||
| City | CANNON AFB |
| Zip Code | 88101 |
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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.