JACK WILLIAMS (NPI# 1629312988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629312988 |
| Entity Type | Individual |
| Full Name | JACK WILLIAMS |
| Credential | IDMT |
| Practice Address |
116 Dickman Dr Dayton OH 45431-1570 |
| Practice Telephone | 5707135461 |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2012-11-26 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275878142 | Jack Parker Williams | Physical Therapy Assistant | 5690 Weaver Rd, Conneaut, OH 44030-9798 | 2012-12-04 |
| 1881823409 | Jack Shelton Williams Jr. | Registered Nurse | 806 Acquoni Rd, Suite 100, Cherokee, NC 28719-0666 | 2009-07-02 |
| 1356454722 | Jack Roger Williams | Dentist | 23706 Malibu Rd, Malibu, CA 90265 | 2006-08-17 |
| 1730195892 | Jack Lawrence Williams | Dentist | 5150 E Stop 11 Rd, Suite 11, Indianapolis, IN 46237-8628 | 2006-07-31 |
| 1053357145 | Jack A Williams | Chiropractor | 204 N Glenwood Avenue, Dalton, GA 30721-3011 | 2006-06-20 |
| 1477906279 | Jack Weston Williams IIi | Pharmacist | 2034 New Castle Ave, New Castle, DE 19720-7703 | 2016-07-15 |
| 1083014633 | Jack Williams Jr. | Community Health Worker | 687 Cheshire Ave, Eugene, OR 97402-5060 | 2014-09-02 |
| 1265658124 | Jack Owen Williams Jr. | Dentist | 3840 Woodruff Ave, Suite 206, Long Beach, CA 90808 | 2007-04-18 |
| 1598738189 | Jack Brook Williams | Specialist | 5454 Wisconsin Ave, Suite 1535, Chevy Chase, MD 20815-6901 | 2006-02-13 |
| Street Address |
116 DICKMAN DR |
| City | DAYTON |
| State | OH |
| Zip Code | 45431-1570 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336768571 | Seth Perry | Student in an Organized Health Care Education/Training Program | Soin Family Medicine, 2145 North Fairfield Road, Suite 100, Beavercreek, OH 45431 | 2020-04-08 |
| 1326680133 | Beavercreek Dental Care Inc | Clinic/Center | 2141 N Fairfield Rd Suite A, Beavercreek, OH 45431 | 2019-10-14 |
| 1487213955 | Hannah Sutherland | Dentist | 3286 Pentagon Park Blvd, Beavercreek, OH 45431 | 2019-06-10 |
| 1598232027 | Holly M Williams | Speech-Language Pathologist | 3038 Kemp Road, Beavercreek, OH 45431 | 2018-11-02 |
| 1770987711 | Tisha Alcorn | Home Health Aide | 327 Canova Ln., Dayton, OH 45431 | 2014-10-20 |
| 1619389301 | Peyman Fattahi | Dentist | 3286 Pentagon Park Blvd., Beavercreek, OH 45431 | 2014-05-29 |
| 1497182992 | Trista Muncy | Social Worker | 100 Elmwood Park Drive Suite 201, Dayton, OH 45431 | 2013-09-30 |
| 1871869636 | Liberty Nursing Center of Beavercreek Inc | Skilled Nursing Facility | 3854 Park Overlooke Drive, Beavercreek, OH 45431 | 2012-03-27 |
| 1750650776 | Emergency Medicine Specialists, Inc | Emergency Medicine | 3535 Pentagon Boulevard, Beavercreek, OH 45431 | 2011-12-20 |
| 1902079213 | Laureene Bollinger | Registered Nurse | 2286 El Cid Dr., Beavercreek, OH 45431 | 2008-04-08 |
| Find all providers in zip 45431 | ||||
| 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 |
|---|---|---|---|---|
| 1992305700 | Jason Patrick Scoles | Military Health Care Provider | 5607 Hickam Dr, Dayton, OH 45431-1544 | 2020-10-30 |
| 1962775890 | Nicole Marie Palko | Military Health Care Provider | 1104 Middy Dr, Dayton, OH 45433-1322 | 2012-02-23 |
| 1326339334 | Brian J Kemp | Military Health Care Provider | 5823 Gross Dr, Dayton, OH 45431-1515 | 2011-04-25 |
| 1033744909 | Joshua Gray Compston | Military Health Care Provider | 4884 Sugar Maple Dr, Dayton, OH 45433-5533 | 2020-03-11 |
| 1730729542 | Alan Eric Piper | Military Health Care Provider | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2020-01-09 |
| 1225681117 | Kaleb Aaron Specht | Military Health Care Provider | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2019-07-19 |
| 1629505656 | Ashley Ann Long | Military Health Care Provider | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2017-05-22 |
| 1881127421 | David Steele | Military Health Care Provider | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2017-04-11 |
| 1124378336 | Stephen Mark Sauer | Military Health Care Provider | 4881 Sugar Maple Dr, Dayton, OH 45431 | 2012-09-14 |
| 1346471216 | Laura Luisa Perry | Military Health Care Provider | 4881 Sugar Maple Dr, Wright Patterson Afb, Oh, Dayton, OH 45433-5546 | 2009-07-27 |
| Find all providers in DAYTON | ||||
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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.