DALLAS MCWILLIAMS (NPI# 1912504093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912504093 |
| Entity Type | Individual |
| Full Name | DALLAS MCWILLIAMS |
| Credential | IDMT |
| Practice Address |
101 Bodin Cir Fairfield CA 94535-1809 |
| Mailing Address |
1229 126th Street Ct E Tacoma WA 98445-7100 |
| Practice Telephone | 7074233000 |
| Mailing Telephone | 2532236417 |
| Enumeration Date | 2020-10-02 |
| Last Update Date | 2020-10-02 |
| 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 |
| Street Address |
101 BODIN CIR |
| City | FAIRFIELD |
| State | CA |
| Zip Code | 94535-1809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082897 | Sahra K. Pak | Dietitian, Registered | 101 Bodin Cir, Fairfield, CA 94535-1809 | 2020-08-03 |
| 1164031407 | Abigail Greenwell | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Fairfield, CA 94535-1809 | 2020-07-22 |
| 1851919468 | Derek P Brady | Military Health Care Provider | 101 Bodin Cir, Fairfield, CA 94535-1809 | 2020-07-09 |
| 1588282396 | Jacob Blotter | Counselor | 101 Bodin Cir, Fairfield, CA 94535-1809 | 2020-07-08 |
| 1154947679 | Daniel Warren Cline | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Fairfield, CA 94535-1809 | 2020-06-20 |
| 1477174654 | Robert Dillon Hill | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Fairfield, CA 94535-1809 | 2020-04-29 |
| 1124653878 | Hana L Ha | Pharmacist | 101 Bodin Cir, Fairfield, CA 94535-1809 | 2020-03-03 |
| 1972137644 | Audrey Nicole Imperial | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Fairfield, CA 94535-1809 | 2020-03-02 |
| 1366074163 | Christian Heinrich Kniep | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Fairfield, CA 94535-1809 | 2020-02-10 |
| 1457983751 | Jeffery Michael Lerma | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Fairfield, CA 94535-1809 | 2020-02-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487711 | Sheila C Flood | Student in an Organized Health Care Education/Training Program | 101 Biden Circle, Fairfield, CA 94535 | 2020-04-28 |
| 1568081255 | Miguel Julian Moreno | Student in an Organized Health Care Education/Training Program | 690 Airmen Drive, Travis Afb, CA 94535 | 2020-04-13 |
| 1174096101 | Zlatoslava Karga | Nurse Practitioner | 60mdg / Sgow, 101 Bodin Circle, Travis Afb, CA 94535 | 2019-01-02 |
| 1437648292 | Luke C Vera | Dentist | David Grant Medical Center 101 Bodin Circle, Travis Air Force Base, CA 94535 | 2018-05-08 |
| 1588163430 | Sanaz Ziad | Pharmacist | 60mdg/mdts, 101 Bodin Circle, Travis Afb, CA 94535 | 2018-02-06 |
| 1194265686 | Geoffrey Johnston | Dentist | 60 Mdg/sgdd, 101 Bodin Circle, Travis Afb, CA 94535 | 2017-03-02 |
| 1336693407 | Hannah Isla Nordwall | Social Worker | 60 Mdg/mdos 101 Bodin Cir, Travis Afb, CA 94535 | 2016-08-06 |
| 1184177149 | Taylor Murrie-robinson | Social Worker | 60mdg / Sgow Mental Health Clinic, 101 Bodin Circle, Travis Afb, CA 94535 | 2016-07-26 |
| 1952759607 | Eric Kincaid-sharp | General Practice | 60 Mdg/amds, 101 Bodin Cir, Travis Afb, CA 94535 | 2016-06-02 |
| 1023472040 | Genieve Marie Martinez-hernandez | Internal Medicine | 60 Mdg/sgomi, 101 Bodin Circle, Fairfield, CA 94535 | 2016-04-06 |
| Find all providers in zip 94535 | ||||
| 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 |
|---|---|---|---|---|
| 1851917165 | Katelyn Renee Watson | Military Health Care Provider | 101 Bodin Drive, Bldg 777, Fairfield, CA 95688 | 2020-06-23 |
| 1942623707 | John Cardona | Military Health Care Provider | 1621 Wallingford Lane, Fairfield, CA 94533 | 2014-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366051294 | Ryan Allan Arriaga | Military Health Care Provider | 1000 Allison Dr, Vacaville, CA 95687-4975 | 2020-07-27 |
| 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 |
| 1184047144 | Austin Puente | Military Health Care Provider | 1069 Butler Dr, Edwards, CA 93523-2622 | 2014-01-28 |
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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.