BAILEY HOLT (NPI# 1568909091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568909091 |
| Entity Type | Individual |
| Full Name | BAILEY HOLT |
| Credential | IDMT |
| Practice Address |
3278 Mitchell Blvd Moody Afb GA 31699-1500 |
| Practice Telephone | 6098329740 |
| Enumeration Date | 2017-01-23 |
| Last Update Date | 2017-01-23 |
| 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 |
3278 MITCHELL BLVD |
| City | MOODY AFB |
| State | GA |
| Zip Code | 31699-1500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811982903 | Yvette Guzman | Pediatrics | 3278 Mitchell Blvd, Moody Afb, Moody Afb, GA 31699-1500 | 2005-09-14 |
| 1578179958 | Lawanna Renee Barron | Social Worker | 3278 Mitchell Blvd, Moody Afb, GA 31699-1500 | 2020-09-21 |
| 1831725381 | Bradley James Connahey | Military Health Care Provider | 3278 Mitchell Blvd, Moody Afb, GA 31699-1500 | 2020-03-17 |
| 1477049781 | Andrew Glidewell | Physician Assistant | 3278 Mitchell Blvd, Moody Afb, GA 31699-1500 | 2018-07-10 |
| 1215431309 | Taylor Montana Martin | Military Health Care Provider | 3278 Mitchell Blvd, Moody Afb, GA 31699-1500 | 2018-03-22 |
| 1982120796 | Byron Reed | Military Health Care Provider | 3278 Mitchell Blvd, Moody Afb, GA 31699-1500 | 2017-08-15 |
| 1770941254 | Ashley Patterson | Contractor | 3278 Mitchell Blvd, Building 900, Moody Afb, GA 31699-1500 | 2016-01-29 |
| 1982088340 | Sarah E Stone | Nurse Practitioner | 3278 Mitchell Blvd, Moody Afb, GA 31699-5529 | 2015-07-16 |
| 1427439165 | Armand Allkanjari | General Practice | 3278 Mitchell Blvd, Moody Afb, GA 31699-1500 | 2015-06-17 |
| 1417362211 | 23rd Medical Group | Pharmacy | 3278 Mitchell Blvd, Moody Afb, GA 31699-1500 | 2014-07-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548771876 | Aldo Enrique Revilla | Psychologist | Bermiss Rd, Moody Afb, Valdosta, GA 31699 | 2017-10-13 |
| 1699903146 | Elizabeth L Fauber | Military Health Care Provider | 9551 Luke Street, Apo, AP 31699 | 2009-06-23 |
| 1063646230 | James Michael White | Military Health Care Provider | 3278 Mithell Blvd, Bldg. 900, Moody Afb, GA 31699 | 2009-05-04 |
| 1265415590 | Rosalie Andrea Castillo | Family Medicine | 347th Medical Group, 3278 Mitchell Blvd, Valdosta, GA 31699 | 2005-11-21 |
| 1902379555 | Amber Leigh Tordoff | Student in an Organized Health Care Education/Training Program | 23d Medical Group 3278 Mitchell Blvd, Building 900, Apo, AA 31699 | 2019-01-07 |
| 1083147367 | Jordan Robbins | Dentist | 23rd Medical Group 3278 Mitchell Blvd, Moody Afb, GA 31699 | 2017-04-04 |
| 1518364678 | Rachel Collins | Specialist/Technologist | 23 Mdos Sgoy, 3278 Mitchell Blvd, Moody Afb, GA 31699-0001 | 2014-12-04 |
| 1083988356 | Brock Allen Mcnabb | Social Worker | 23rd Medical Group 3278 Mitchell Blvd, Moody Afb, GA 31699-0001 | 2012-03-02 |
| 1760711162 | Christopher Wayne Daniels | Physician Assistant | 23 Medical Group, 3278 Mitchell Blvd, Moody A F B, GA 31699-0001 | 2009-12-14 |
| 1447487749 | Roong Robert Burket | Military Health Care Provider | 347 Oss Osm, Moody A F B, GA 31699-0001 | 2009-06-15 |
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| 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 |
|---|---|---|---|---|
| 1881905073 | Chun Chung Fong | Military Health Care Provider | 3278 Mitchell Blvd Bldg 900, Moody Afb, GA 31699-1500 | 2010-06-23 |
| 1063646230 | James Michael White | Military Health Care Provider | 3278 Mithell Blvd, Bldg. 900, Moody Afb, GA 31699 | 2009-05-04 |
| 1043453459 | Lisa Vega | Military Health Care Provider | 647 Robinson Rd, Moody Afb, GA 31699-0001 | 2009-04-15 |
| 1831725381 | Bradley James Connahey | Military Health Care Provider | 3278 Mitchell Blvd, Moody Afb, GA 31699-1500 | 2020-03-17 |
| 1982120796 | Byron Reed | Military Health Care Provider | 3278 Mitchell Blvd, Moody Afb, GA 31699-1500 | 2017-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003459942 | Summer Ann Felix | Military Health Care Provider | 4260 Nelson Hill Pl, Hahira, GA 31632-3264 | 2019-10-23 |
| 1811397243 | Kristy Luna | Military Health Care Provider | 2331 Downing Ave, Savannah, GA 31404-3953 | 2014-09-04 |
| 1952701641 | Alan Vega | Military Health Care Provider | 3715 N Valdosta Rd Apt 82, Valdosta, GA 31602 | 2014-08-29 |
| 1548697485 | John Dye Jr. | Military Health Care Provider | 655 Seventh St., Robins Afb, GA 31098 | 2013-10-10 |
| 1306189576 | Rebecca Lynne Lozano | Military Health Care Provider | 620 Randolph Ave, Warner Robins, GA 31098-1162 | 2013-04-05 |
| 1205110368 | Brian Russell Balcolm | Military Health Care Provider | 4099 Forrest Run Cir, Valdosta, GA 31605-6538 | 2011-10-06 |
| 1689957862 | Monique Nicole Toth | Military Health Care Provider | 3748 Robin Ln, Valdosta, GA 31605-5102 | 2011-09-23 |
| 1316230527 | Tamara Alisha Ivy | Military Health Care Provider | 138 Washington Ave, Waynesboro, GA 30830-8421 | 2011-05-20 |
| 1114221439 | Stephanie Denise Sulewski | Military Health Care Provider | 1063 Uss Tennessee Ave, Avenue Ql 11, Kings Bay, GA 31547-2606 | 2010-12-29 |
| 1194033365 | Jessica Marie Barker | Military Health Care Provider | 317 Simms Rd, Carrollton, GA 30117-5611 | 2010-09-21 |
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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.