MATTHEW HETRICK (NPI# 1821614538) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821614538 |
| Entity Type | Individual |
| Full Name | MATTHEW HETRICK |
| Credential | IDMT |
| Practice Address |
1100 Wilford Hall Loop Jbsa Lackland TX 78236-5638 |
| Practice Telephone | 7248595789 |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2020-06-18 |
| 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 |
|---|---|---|---|---|
| 1750934386 | Matthew Hetrick | Pharmacist | 3420 Sw 34th Avenue Cir, Ocala, FL 34474-3303 | 2019-07-23 |
| Street Address |
1100 WILFORD HALL LOOP |
| City | JBSA LACKLAND |
| State | TX |
| Zip Code | 78236-5638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134113954 | Monica L. Wheaton | Advanced Practice Midwife | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2005-09-08 |
| 1811509763 | Megan Dial | Physical Therapist | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2020-08-21 |
| 1689297368 | Rachel E Hodge | Nurse Practitioner | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2020-05-28 |
| 1598385742 | Tora Jean Tornbom | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop, Bldg 4554, 59 Mdw/gme, Jbsa Lackland, TX 78236-5638 | 2020-04-17 |
| 1689236622 | Jessica Martinez Bennett | Nurse Practitioner | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2019-06-29 |
| 1073172565 | Robert A Kowtoniuk | General Practice | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2019-06-10 |
| 1972167161 | Jordan Ellis | Psychologist | 1100 Wilford Hall Loop, Bldg. 4554, 59 Mdw/gme, Jbsa Lackland, Jbsa Lackland, TX 78236 | 2019-04-24 |
| 1124580311 | Christopher Berrios | Military Health Care Provider | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2019-04-05 |
| 1801352539 | Aeja Weiss | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2019-02-19 |
| 1083170252 | Kristen Garvie | General Practice | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2019-02-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
| 1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
| 1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
| 1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
| 1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
| 1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
| 1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
| 1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
| 1376906958 | David Kephart Jr. | General Practice | 1100 Wilford Hall Loop Bldg 4454, Jbsa Lackland, TX 78236 | 2016-04-01 |
| 1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
| Find all providers in zip 78236 | ||||
| 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 |
|---|---|---|---|---|
| 1124580311 | Christopher Berrios | Military Health Care Provider | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2019-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453145 | Ian Frogley | Military Health Care Provider | Jbsa 2230 Hughes Ave, San Antonio, TX 78236-8404 | 2020-10-06 |
| 1861099939 | Andrew Goebel | Military Health Care Provider | 1800 Truemper St, San Antonio, TX 78236-5510 | 2020-10-02 |
| 1790382844 | Kyle Schachsieck | Military Health Care Provider | 2800 Winfield Scott Rd Ste 347, Fort Sam Houston, TX 78234-7662 | 2020-10-01 |
| 1861018178 | John C Gallik | Military Health Care Provider | 3176 Corporal Johnson Road, Jbsa Fort Sam Houston, TX 33809 | 2020-06-23 |
| 1376169086 | Colton Wayne Dickens | Military Health Care Provider | 5415 N Foster Rd Apt 8306, San Antonio, TX 78244-2405 | 2020-06-18 |
| 1750924692 | Michelle Lynn Hernando | Military Health Care Provider | 109 Kentucky St, Dyess Afb, TX 79607-1007 | 2019-10-23 |
| 1598315061 | Matthew Scott Floores | Military Health Care Provider | 7303 S Ute Trl, Austin, TX 78729-7756 | 2019-09-17 |
| 1427529650 | Riley Pearl Solomon | Military Health Care Provider | 6419 N Vandiver Rd Apt 2203, Alamo Heights, TX 78209-4484 | 2018-12-16 |
| 1588135719 | Alejandro Daniel Perez | Military Health Care Provider | Wilderness Trl & Camp Bullis, San Antonio, TX 78257 | 2018-12-16 |
| 1861969271 | Jose A Sanchez | Military Health Care Provider | 15425 Bobwhite Quail, San Antonio, TX 78253-6621 | 2018-10-24 |
| Find all providers with the same taxonomy | ||||
| City | JBSA LACKLAND |
| Zip Code | 78236 |
Please comment or provide details below to improve the information on MATTHEW HETRICK.
| 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.