TRACEY L GILMORE


Address: 3739 W Helena Dr, Glendale, AZ 85308-3105
Phone: 4814146513

TRACEY L GILMORE (NPI# 1376779959) 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) 1376779959
Entity Type Individual
Full Name TRACEY L GILMORE
Credential IDMT
Practice Address 3739 W Helena Dr
Glendale
AZ 85308-3105
Practice Telephone 4814146513
Mailing Telephone 4804146513
Enumeration Date 2009-06-09
Last Update Date 2009-06-09
Gender Code F
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 3739 W HELENA DR
City GLENDALE
State AZ
Zip Code 85308-3105

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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
1053617464 Bradley William Snyder Military Health Care Provider 7224 North 139th Avenue, Glendale, AZ 85309 2011-02-02
1578103461 Benjamin Andrew Gallentine Military Health Care Provider 7219 N Litchfield Rd, Glendale, AZ 85309-1529 2020-01-09
1316245764 Anthony Bradford Wilson Military Health Care Provider 7219 N Litchfield Rd, Glendale, AZ 85309-1529 2011-03-09

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1225657828 Casey Mulcahy Military Health Care Provider 2748 N 60th St, Scottsdale, AZ 85257-1012 2020-04-13
1194375667 Nathan Andrew Lawson Military Health Care Provider 2336 E Libra Pl, Chandler, AZ 85249-3790 2019-09-17
1043787450 Dustin Alford Military Health Care Provider 4280 E Burnsey Ln, Kingman, AZ 86401-5595 2018-10-24
1306259171 Aaron Alvarez Military Health Care Provider 18026 W Carol Ave, Waddell, AZ 85355-4127 2014-06-09
1891118774 Vianca Mendoza Military Health Care Provider 17714 W Desert Ln, Surprise, AZ 85388-1714 2014-01-28
1831449180 Ronald John Borgstrom II Military Health Care Provider 15053 W Mulberry Dr, Goodyear, AZ 85395-8846 2012-09-13
1821358102 Ngu Quang Do Military Health Care Provider 407 Campbell St, Prescott, AZ 86301-2518 2012-05-21
1043516610 Charles Delvon Pickett Military Health Care Provider 7019 N Litchfield Ave, Luke Afb, 56/amds, Luke Afb, AZ 85309 2011-01-31
1235433756 Esmat Marie Sabbagh Military Health Care Provider 5020 E Arizola St, Davis Monthan Afb, AZ 85707-3108 2010-12-23
1417267949 Humberto Alcocer Military Health Care Provider 4159 W 3rd Pl, Yuma, AZ 85364-1009 2010-10-18
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Competitor

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City GLENDALE
Zip Code 85308

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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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