JODI CLARY (NPI# 1376778407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376778407 |
| Entity Type | Individual |
| Full Name | JODI CLARY |
| Credential | IDMT |
| Practice Address |
280 1st St Bldg 15 Holloman Afb NM 88330-8273 |
| Practice Telephone | 5755727985 |
| Mailing Telephone | 5755727985 |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2009-05-19 |
| 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 |
Other Service Providers |
| Street Address |
280 1ST ST BLDG 15 |
| City | HOLLOMAN AFB |
| State | NM |
| Zip Code | 88330-8273 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568606317 | Kimberly Dawn Jensen | Internal Medicine | 280 1st St Bldg 15, 49 Mdg Holloman Afb, Holloman Afb, NM 88330 | 2009-04-23 |
| 1356755185 | 49th Medical Group | Military/U.S. Coast Guard Pharmacy | 280 1st St Bldg 15, Holloman Afb, NM 88330-8273 | 2014-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598312084 | Zachary James Smith | Pharmacist | 49th Medical Group 280 First Street, Holloman Afb, NM 88330 | 2019-08-20 |
| 1346776804 | Maxilea Isom | Behavior Technician | 2079 Eglin Ave Apt A, Holloman, Afb, NM 88330 | 2017-05-03 |
| 1932558665 | Courtney Davis | Day Training/Habilitation Specialist | 2228 La Luz Pkwy Unit A, Holloman Afb, NM 88330 | 2016-06-03 |
| 1568849255 | Ryan Abner | Registered Nurse | 49th Medical Building 17, Holloman Afb, NM 88330 | 2015-05-01 |
| 1710384292 | United States Air Force | Military Hospital | 49th Medical Bldg 17, Holloman Afb, NM 88330 | 2014-11-26 |
| 1174934764 | Jason Gordon | Social Worker | 1st Street Holloman Afb, Holloman Afb, NM 88330 | 2014-05-16 |
| 1649512807 | Philip Walker | Internal Medicine | 280 1st St, Holloman Afb, Alamogordo, NM 88330 | 2013-03-25 |
| 1275891889 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | 551 4th Street, Bldg. 227, Holloman Afb, NM 88330 | 2012-05-02 |
| 1700042306 | Bettina Watkins | Family Medicine | 280 First St, Bldg 23, Holloman Afb, NM 88330 | 2008-08-03 |
| 1386849024 | Matthew Atwood | Social Worker | 200 First St., Bldg 17, Holloman Afb, NM 88330 | 2007-06-20 |
| Find all providers in zip 88330 | ||||
| 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 |
|---|---|---|---|---|
| 1750907465 | Noah Johnson | Military Health Care Provider | 280 1st St Bldg 23, Holloman Afb, NM 88330-8273 | 2020-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496625 | Stephen Kreidler | Military Health Care Provider | 5453 Roosevelt Loop Ne, Rio Rancho, NM 87144-5218 | 2020-10-30 |
| 1134748692 | Patrick James Scollon | Military Health Care Provider | 104 W D. L. Ingram Ave, Cannon Afb, Nm 88101, Cannon Afb, NM 88101 | 2020-04-14 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | HOLLOMAN AFB |
| Zip Code | 88330 |
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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.