JENNIFER DENISE MATHIS (NPI# 1467707638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467707638 |
| Entity Type | Individual |
| Full Name | JENNIFER DENISE MATHIS |
| Credential | IDMT |
| Practice Address |
913 Claeven Cir Fort Walton Beach FL 32547-4257 |
| Practice Telephone | 2283260922 |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2012-07-13 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619384989 | Jennifer Mathis | Counselor | 815 Mission Ave Ste 208, Oceanside, CA 92054-2841 | 2014-07-17 |
| 1346513926 | Jennifer Z Mathis | Speech-Language Pathologist | 5603b W Friendly Ave # 274, Greensboro, NC 27410-4213 | 2012-02-13 |
| 1124303359 | Jennifer Mathis | Pharmacist | 5006 Old Hickory Blvd, Hermitage, TN 37076-2566 | 2011-10-19 |
| 1548304892 | Jennifer Mathis | Family Medicine | 1300 N 12th St Ste 608, Phoenix, AZ 85006-2850 | 2007-02-19 |
| 1548368988 | Jennifer Lynne Mathis | Counselor | 3015 E Skelly Dr, Suite 390, Tulsa, OK 74105-6317 | 2006-09-20 |
| Street Address |
913 CLAEVEN CIR |
| City | FORT WALTON BEACH |
| State | FL |
| Zip Code | 32547-4257 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255944955 | Theresa Ann Morvay | Behavior Technician | 419 Racetrack Rd Ne, Fort Walton Beach, FL 32547 | 2020-08-24 |
| 1588295422 | Emily Ann Glossop | Nurse Practitioner | 930 Mar Walt Drive C, Fort Walton Beach, FL 32547 | 2020-01-29 |
| 1225669443 | Elizabeth Rogers Nagengast | Physician Assistant | 930 Mar Walt Drive, Unit C, Fort Walton Beach, FL 32547 | 2020-01-27 |
| 1497254791 | Carmen Alston | Nurse Practitioner | 930 Mar Walt Dr C, Fort Walton Beach, FL 32547 | 2018-02-02 |
| 1871004960 | Center for Neuropsychological Services Cns | Clinical Neuropsychologist | 1817 Lewis Turner Blvd, Fort Walton Beach, FL 32547 | 2017-10-17 |
| 1194235648 | Robin Wray | Speech-Language Pathologist | 930 Mar Walt Dr D, Fort Walton Beach, FL 32547 | 2017-10-10 |
| 1285007989 | Dynamic Pain & Wellness Pllc | Pain Medicine | 930 Marwalt Drive, Suite B and C, Fort Walton Beach, FL 32547 | 2015-11-04 |
| 1013392810 | Terry Abbott | Social Worker | 648 Overbrook Dr, Fort Walton Beach, FL 32547 | 2015-07-22 |
| 1083024673 | Emily Lohr | Physical Therapy Assistant | 2000 Principle Ln, Ft. Walton Beach, FL 32547 | 2014-05-05 |
| 1831526102 | Laurie Ann Schweppe | Nurse Practitioner | 1005 Mar Walt Drivve, Snf Hospitalist Department, Fort Walton Beach, FL 32547 | 2013-10-02 |
| Find all providers in zip 32547 | ||||
| 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 |
|---|---|---|---|---|
| 1568605855 | Richard Nick Norland | Military Health Care Provider | 309 Chickasaw Cir, Fort Walton Beach, FL 32547-3514 | 2009-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457994394 | Nathaniel Clay Hollandsworth | Military Health Care Provider | 517 Harrison Dr, Hurlburt Field, FL 32544-1100 | 2019-10-23 |
| 1316592355 | Tiffany Nicole Monroe | Military Health Care Provider | 6280 Ferguson Dr, Pensacola, FL 32503-7769 | 2019-08-06 |
| 1881197069 | David Joseph Bergstrom | Military Health Care Provider | 2293 Frontera St, Navarre, FL 32566-6202 | 2018-03-14 |
| 1144723321 | Paris Johnae Milton | Military Health Care Provider | 340 Magnolia Cir # 5612, Tyndall Afb, FL 32403-5604 | 2018-03-14 |
| 1538681226 | Qynne M Shoemaker | Military Health Care Provider | 1008 E Strawbridge Ave, Melbourne, FL 32901-4909 | 2017-07-13 |
| 1891196531 | Lorex Boy Lagora | Military Health Care Provider | 1010 Nw 91st St, Miami, FL 33150-2352 | 2014-09-12 |
| 1366865321 | Stephanie Fike | Military Health Care Provider | 2804 Winners Circle Dr, Navarre, FL 32566-8820 | 2014-01-28 |
| 1639506579 | Aaron Newby | Military Health Care Provider | 3434 Skysail Pl, Tampa, FL 33607-5828 | 2013-10-10 |
| 1821439712 | Eric John Muelhausen | Military Health Care Provider | 6151 Evergreen Pkwy, Crestview, FL 32539-7702 | 2013-07-09 |
| 1457790875 | Caige Carter Chapman | Military Health Care Provider | 1935 Jo Tam Lane, Navarre, FL 32566 | 2013-06-19 |
| Find all providers with the same taxonomy | ||||
| City | FORT WALTON BEACH |
| Zip Code | 32547 |
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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.