MR. THOMAS GLENNON MOORE (NPI# 1851525026) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851525026 |
| Entity Type | Individual |
| Full Name | MR. THOMAS GLENNON MOORE |
| Credential | IDMT |
| Practice Address |
6475 Warrior Way Bldg. 1938 Hill Afb UT 84056-5974 |
| Mailing Address |
4296 Appomattox Cir Apt A Hill Afb UT 84056-1572 |
| Practice Telephone | 8017770658 |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2009-05-04 |
| 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 |
|---|---|---|---|---|
| 1700410081 | Thomas Earl Moore | Nurse Practitioner | 5575 Dana Dr, Ashland, KY 41102-9647 | 2020-02-26 |
| 1760923775 | Thomas Moore II | Physical Therapist | 5100 Paschall Dr, Durham, NC 27705-8534 | 2017-03-10 |
| 1437509429 | Thomas Anthony Moore | Occupational Therapist | 180 Thompson Rd, Crossville, TN 38571-0755 | 2016-06-21 |
| 1871970194 | Thomas Edward Moore | Counselor | 3937 S St Se Apt A8, Washington, DC 20020-1009 | 2015-05-06 |
| 1184039364 | Thomas Moore | Psychologist | 169 Libbey Industrial Pkwy Fl 2, Weymouth, MA 02189-3101 | 2014-06-25 |
| 1821372087 | Thomas Lowell Moore | Counselor | 1711 Hermitage Dr, Florence, AL 35630-2517 | 2011-10-06 |
| 1457537896 | Thomas L Moore | Counselor | 310 E. Lake St., Tom Moore, Mccall, ID 83638 | 2008-01-16 |
| 1376740126 | Thomas Moore Jr. | Social Worker | 2630 Skylark Rd, Wilmington, DE 19808-1634 | 2007-06-27 |
| 1013123561 | Thomas Marion Moore | Pharmacist | 4305 Peninsula Pt, Greenville, NC 27834-0520 | 2007-05-14 |
| 1164580221 | Thomas James Moore | Family Medicine | 99 E Carmel Drive, Suite E, Carmel, IN 46032 | 2006-12-04 |
| Street Address |
6475 WARRIOR WAY BLDG. 1938 |
| City | HILL AFB |
| State | UT |
| Zip Code | 84056-5974 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003050360 | Victoria M Weiger | Military Health Care Provider | 6475 Warrior Way, 729 Acs/sg, Hill Afb, UT 84056-5961 | 2009-04-29 |
| 1639402308 | Stephen Jackson Chambers | Military Health Care Provider | 6475 Warrior Way, Building 1948, Hill Afb, UT 84056-5961 | 2009-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629639885 | Brian A Silva | Physician Assistant | 7321 Balmer Street Bldg 570, Hill Air Force Base, UT 84056 | 2019-06-27 |
| 1245767045 | Keith Mele | Pharmacist | 7457 Weiner Street, Hill Air Force Base, UT 84056 | 2017-05-11 |
| 1235513540 | Joshua David Stumpf | Military Health Care Provider | 570 Balmer Street, Hill Afb, UT 84056 | 2015-07-16 |
| 1194107912 | Kelly Johnson | Social Worker | 75 Mdg, Mental Health Clinic, 7309 Balmer Street, Bldg 545, Hill Afb, UT 84056 | 2015-06-29 |
| 1831449156 | Curt G Martin | Dentist | 7321 Balmer, 75 Mdg, Hill Afb, UT 84056 | 2012-09-13 |
| 1811253222 | Tiffany Amber Brakefield | Psychologist | 7309 Balmer St Bldg 545, Hill Afb, UT 84056 | 2012-04-10 |
| 1982910907 | Peter Shigeki Frandsen | Dentist | 7321 Balmer Street Bldg #570, Hill Afb, 75th Mdg/sgd, Hill Afb, UT 84056 | 2010-08-27 |
| 1861625436 | Michael David Brewer | Family Medicine | 7321 Balmer Ave, Hill Afb, UT 84056 | 2009-08-31 |
| 1780838789 | Nisha Ray Baur | Pediatrics | Bldg 569 Hill Afb, Clearfield, UT 84056 | 2008-11-05 |
| 1629230669 | Elizabeth A. Sherlock | Psychologist | 75 Mdg/sghc, 7321 11th Street, Bldg. 570, Hill Afb, UT 84056 | 2008-07-01 |
| Find all providers in zip 84056 | ||||
| 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 |
|---|---|---|---|---|
| 1235513540 | Joshua David Stumpf | Military Health Care Provider | 570 Balmer Street, Hill Afb, UT 84056 | 2015-07-16 |
| 1427322353 | Jeffrey C Guerttman | Military Health Care Provider | 4067 Roxbury Cir Apt B, Hill Afb, UT 84056-1346 | 2012-02-23 |
| 1366672750 | Dane J Tackitt | Military Health Care Provider | 7338 Loncki St, Hill Afb, UT 84056-7300 | 2009-07-20 |
| 1568696599 | Deborah Ann Ciesla | Military Health Care Provider | 7985 Browning St Bldg 1781, Hill Afb, UT 84056-5912 | 2009-05-05 |
| 1003050360 | Victoria M Weiger | Military Health Care Provider | 6475 Warrior Way, 729 Acs/sg, Hill Afb, UT 84056-5961 | 2009-04-29 |
| 1730322926 | Tamera Jo Hall | Military Health Care Provider | 7321 Balmer St Bldg 569, Hill Afb, UT 84056-5012 | 2009-04-17 |
| 1639402308 | Stephen Jackson Chambers | Military Health Care Provider | 6475 Warrior Way, Building 1948, Hill Afb, UT 84056-5961 | 2009-09-14 |
| 1477781953 | Ray J Angel | Military Health Care Provider | 7321 Balmer St, Hill Afb, UT 84056-5012 | 2009-06-23 |
| 1295962207 | Patricia Mottram | Military Health Care Provider | 7321 Balmer St Bldg 569, Hill Afb, UT 84056-5012 | 2009-06-17 |
| 1831333129 | Nathan Michael Leeman | Military Health Care Provider | 7321 Balmer St, Bldg 570, Hill Afb, UT 84056-5012 | 2009-04-30 |
| Find all providers in HILL AFB | ||||
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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.