COLIN MICHAEL MULLALY


Address: 5955 Zeamer Ave, Anchorage, AK 99506-3702
Phone: 9075802070

COLIN MICHAEL MULLALY (NPI# 1912481656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1912481656
Entity Type Individual
Full Name COLIN MICHAEL MULLALY
Credential IDMT
Practice Address 5955 Zeamer Ave
Anchorage
AK 99506-3702
Mailing Address 5955 Zeamer Ave
Anchorage
AA 99508
Practice Telephone 9075802070
Enumeration Date 2018-09-19
Last Update Date 2018-09-19
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1710I1003X Military Health Care Provider
Specialization: Independent Duty Medical Technicians
Other Service Providers

Office Location

Street Address 5955 ZEAMER AVE
City ANCHORAGE
State AK
Zip Code 99506-3702

Providers in the same location

NPI Name Taxonomy Address Enumeration
1780172122 Kathryn Noel Nyunt Military Health Care Provider 5955 Zeamer Ave, Anchorage, AK 99506-3702 2018-05-01
1720587900 Cody Mckenzie Pharmacist 5955 Zeamer Ave, Anchorage, AK 99506-3702 2018-02-02
1568995231 Michele Lewis Prevention Professional 5955 Zeamer Ave, Anchorage, AK 99506-3702 2017-04-09
1275071367 Daniel Thomas Perez Nurse Anesthetist, Certified Registered 5955 Zeamer Ave, Anchorage, AK 99506-3702 2017-02-08
1063897643 Kevin Trimble Nurse Practitioner 5955 Zeamer Ave, Anchorage, AK 99506-3702 2015-07-24
1356735948 Sarah Nelin General Practice 5955 Zeamer Ave, Anchorage, AK 99506 2015-03-23
1346632361 Steven Ferrell Emergency Medicine 5955 Zeamer Ave, Anchorage, AK 99506-3702 2015-02-27
1760872428 Deana Kubosh Occupational Therapist 5955 Zeamer Ave, Anchorage, AK 99506-3702 2015-02-02
1669898623 Department of Defense Registered Nurse 5955 Zeamer Ave, Anchorage, AK 99506-3702 2014-03-13
1174948368 Steven L Maya Physician Assistant 5955 Zeamer Ave, Anchorage, AK 99506-3702 2014-02-24
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1538797279 Mark Pulver Social Worker 673mdg, Zeamer Avenue, Joint Base Elmendorf-richardson, AK 99506 2020-03-30
1871052837 Ryan Kenny Zarnowski Dentist 673 Mdg, 5955 Zeamer Avenue, Jber, Ak 99506, Apo, AA 99506 2019-03-18
1679056659 Bennett Robert Stadler Physician Assistant 673 Mdg 5955 Zeamer Avenue, Jber, AK 99506 2018-09-14
1437678687 Mary Ann Barnard Nurse Practitioner Joint Base Elmendorf-richardson Hospital, 5955 Zeamer Ave, Anchorage, AK 99506 2017-09-19
1205375698 Kuuipo Lau Social Worker 673d Mdg, 5955 Zeamer Ave., Jber, AK 99506 2017-02-17
1427434315 Vance Knauer Dentist 673mdg 5955 Zeamer Ave, Jber, AK 99506 2015-08-03
1295112159 Jacob Eby Pediatrics 673 Mdg 5955 Zeamer Ave, Jber, AK 99506 2015-04-29
1174956338 Scott M Cheney Physical Therapist 673mdg, 5955 Zeamer Ave, Jber, AK 99506 2013-08-12
1518305580 Jennifer Lynn Robison Physician Assistant 65955 Zeamer Avenue, Jber, AK 99506 2013-06-12
1588939664 Paul Aaron Garrett Emergency Medicine 673rd Mdg, 5955 Zeamer Avenue, Jber, Apo, AA 99506 2012-03-21
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Taxonomy Information

Taxonomy Code 1710I1003X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Medical Technicians

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1780172122 Kathryn Noel Nyunt Military Health Care Provider 5955 Zeamer Ave, Anchorage, AK 99506-3702 2018-05-01

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1861093304 Ryan Garcia Military Health Care Provider 673d Med Group, Jber, AK 99501 2020-11-02
1447850268 Ryan Rene Reyes Military Health Care Provider 1024 Nordale Rd, North Pole, AK 99705-5154 2020-10-30
1285055129 Jennifer Trout Military Health Care Provider 18226 Pioneer Dr, Eagle River, AK 99577-9331 2013-12-19
1063649234 John Michael Strothenke Military Health Care Provider 2630 Central Avenue Suite 1, 354 Medical Operations Squadron, Clinical Medicine Flt, Eielson Air Force Base, AK 99702 2009-06-16
1225272073 Landru Derek Medvec Military Health Care Provider 2422 Arctic Ave, Apt D, Eielson Afb, AK 99702 2009-04-23
1578189387 Eric Dylan Mason Military Health Care Provider 2630 Central Ave, Eielson Afb, AK 99702-2301 2020-06-18
1518586122 Amanda Nichols Military Health Care Provider 2630 Central Ave # 3349, Eielson Afb, AK 99702-2301 2020-04-14
1851853048 Jordan Matthew Cate Military Health Care Provider 5955 Zeamer Ave, Jber, AK 99506-3702 2019-04-05
1457810657 Mycala B Stedingh Military Health Care Provider 673 Mdg, 5955 Zeamer Ave, Jber, AK 99506 2019-03-18
1104393446 Matthew Gray Military Health Care Provider 2630 Central Ave, Eielson Afb, AK 99702-2301 2018-10-24
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Competitor

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City ANCHORAGE
Zip Code 99506

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Dataset Information

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.

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