LARRY W. PAYNE (NPI# 1679732143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679732143 |
| Entity Type | Individual |
| Full Name | LARRY W. PAYNE |
| Credential | HEALTH SERVICES TECH |
| Practice Address |
599 Tomales Rd Petaluma CA 94952-5002 |
| Practice Telephone | 7077657275 |
| Practice Fax Number | 7077657495 |
| Mailing Telephone | 7077657275 |
| Mailing Fax Number | 7077657495 |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2008-06-09 |
| 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 |
|---|---|---|---|---|
| 1952670549 | Larry Allen Payne | Counselor | 8015 Woodrow Rd, Wolfforth, TX 79382-4381 | 2011-12-28 |
| 1487703286 | Larry G Payne | Dentist | 605 S Wayne St, Waterloo, IN 46793-9472 | 2007-01-09 |
| 1366504474 | Larry Jeffrey Payne | Ophthalmology | 1485 Jesse Jewell Parkway Ne, Suite 100, Gainesville, GA 30501 | 2006-12-14 |
| 1316011067 | Larry C Payne | Chiropractor | 670 River Oaks Pkwy Ste K, San Jose, CA 95134-1988 | 2006-11-17 |
| 1689795148 | Larry Jason Payne | Dentist | 4965 Friendship Rd, Suite 105, Buford, GA 30518-1700 | 2007-04-03 |
| Street Address |
599 TOMALES RD |
| City | PETALUMA |
| State | CA |
| Zip Code | 94952-5002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831167717 | Randall Carl Lucas | Technician, Other | 599 Tomales Rd, Petaluma, CA 94952-5002 | 2006-03-08 |
| 1164069480 | Eliza Zetino | Dental Assistant | 599 Tomales Rd, Petaluma, CA 94952-5002 | 2019-12-05 |
| 1467698662 | Jami Rene Moore | Technician, Other | 599 Tomales Rd, Petaluma, CA 94952-5002 | 2008-12-18 |
| 1740426931 | Maureen Huber | Technician, Other | 599 Tomales Rd, Petaluma, CA 94952-5002 | 2008-12-18 |
| 1831334168 | Yamil N Vazquez | Technician, Other | 599 Tomales Rd, Petaluma, CA 94952 | 2008-12-16 |
| 1740425073 | Ryan Richard Jablonowski | Technician, Other | 599 Tomales Rd, Petaluma, CA 94952-5002 | 2008-12-16 |
| 1417192840 | Ashton L. Atkins | Technician, Other | 599 Tomales Rd, Petaluma, CA 94952-5002 | 2008-12-15 |
| 1053556480 | Rachel Elaine Burton | Technician, Other | 599 Tomales Rd, Petaluma, CA 94952-5002 | 2008-12-15 |
| 1962647396 | Nichole Danielle Mccarthy | Technician, Other | 599 Tomales Rd, Petaluma, CA 94952-5002 | 2008-12-15 |
| 1407091838 | William Matthew Hilt | Technician, Other | 599 Tomales Rd, Petaluma, CA 94952-5002 | 2008-12-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114587680 | Benjamin R Idarius | Behavior Technician | 101 H St. Ste. L, Petaluma, CA 94952 | 2019-06-17 |
| 1518457159 | Kyleen Joan Romero | Behavioral Analyst | 25 Graylawn Ave, Petaluma, CA 94952 | 2018-05-17 |
| 1437647526 | John Scruggs | Behavior Technician | 301 H St. Suit L, Petaluma, CA 94952 | 2018-04-25 |
| 1811404684 | Brief and Strategic Counseling Service | Counselor | 843 Chardonnay Cir., Petaluma, CA 94952 | 2018-01-03 |
| 1730638396 | Jennifer Lee Sloan | Acupuncturist | 517 Hayes Lane, Petaluma, CA 94952 | 2016-09-23 |
| 1982057295 | Elene Hwa-yihg Chung | Acupuncturist | 130 Graylawn Ave.,#f, Petaluma, CA 94952 | 2016-07-21 |
| 1457773624 | Lisa Hirsch Cordeiro | Marriage & Family Therapist | 700 Sixth Street, Petaluma, CA 94952 | 2014-01-07 |
| 1811271075 | Jacques Philippe Archer | Massage Therapist | 131b Kentucky St., Petaluma, CA 94952 | 2011-10-06 |
| 1477841609 | Karna Licia Dawson | Social Worker | 205 Keller St., Petaluma, CA 94952 | 2011-07-21 |
| 1497051783 | Melissa Beth Wilson | Acupuncturist | 155a Kentucky Street, Petaluma, CA 94952 | 2011-02-03 |
| Find all providers in zip 94952 | ||||
| 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 |
|---|---|---|---|---|
| 1396947651 | Orlando L Mayo | Military Health Care Provider | 599 Tomales Rd, Ralph R. Nix Clinic, Petaluma, CA 94952-5002 | 2007-05-31 |
| 1396883567 | Robert Theodore Kulbeth | Military Health Care Provider | 599 Tomales Rd, Petaluma, CA 94952-5002 | 2007-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366051294 | Ryan Allan Arriaga | Military Health Care Provider | 1000 Allison Dr, Vacaville, CA 95687-4975 | 2020-07-27 |
| 1851917165 | Katelyn Renee Watson | Military Health Care Provider | 101 Bodin Drive, Bldg 777, Fairfield, CA 95688 | 2020-06-23 |
| 1558911024 | Christopher Andersen | Military Health Care Provider | 1000 Allison Dr Apt 183, Vacaville, CA 95687-4988 | 2019-09-17 |
| 1558873968 | Giovanni Oddo | Military Health Care Provider | 25051 Mawson Dr, Laguna Hills, CA 92653-5263 | 2017-10-26 |
| 1730606658 | Jeffrey Rodriguez | Military Health Care Provider | 975 Carl Cir, Edwards, CA 93523-1906 | 2017-08-23 |
| 1154847960 | James Edward Schafer | Military Health Care Provider | 883 Covey Ct, Hollister, CA 95023-8906 | 2017-08-15 |
| 1437551702 | Jonathan Saplan | Military Health Care Provider | 1411 Pelican Way, Suisun City, CA 94585-2330 | 2014-09-18 |
| 1093124398 | Benjamin Ryan Foy | Military Health Care Provider | 2784 Hornet Way, San Diego, CA 92106-6421 | 2014-08-12 |
| 1598182214 | Matthew Wheaton Burns | Military Health Care Provider | 105 Colorado St, Travis Afb, CA 94535-1255 | 2014-03-19 |
| 1508282658 | April Summers | Military Health Care Provider | 2205 Farrell Ave Apt 204, Redondo Beach, CA 90278-1846 | 2014-03-13 |
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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.