MR. MICHAEL B STULL (NPI# 1952630642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952630642 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL B STULL |
| Credential | IDMT |
| Practice Address |
904 S Dallas Ave Apt 3 Portales NM 88130-6028 |
| Practice Telephone | 5757840287 |
| Enumeration Date | 2009-12-09 |
| Last Update Date | 2010-08-19 |
| 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 |
|---|---|---|---|---|
| 1366684060 | Michael E Stull | Emergency Medicine | 3636 High St, Portsmouth, VA 23707-3236 | 2009-03-27 |
| Street Address |
904 S DALLAS AVE APT 3 |
| City | PORTALES |
| State | NM |
| Zip Code | 88130-6028 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245861319 | Cynthia Alarid | Student in an Organized Health Care Education/Training Program | 1500 S Ave K Station 3, Schroc, Portales, NM 88130 | 2020-01-28 |
| 1649800384 | Gurveen Sandhu | Student in an Organized Health Care Education/Training Program | 1500 S Ave. K Station 3, Shroc, Portales, NM 88130 | 2020-01-22 |
| 1740744226 | Ashley Mcclelland | Student in an Organized Health Care Education/Training Program | 1500 S. Avenue K, Station 3 Shroc, Portales, NM 88130 | 2019-01-29 |
| 1285103218 | Jessica Dianne Terry | Behavior Technician | 743 S Hills Oak Rd, Portales, NM 88130 | 2018-11-20 |
| 1619445822 | Jonna Smith | Marriage & Family Therapist | 44 S Roosevelt Road N, Portales, NM 88130 | 2018-11-06 |
| 1932689254 | Carolina Yanez | Student in an Organized Health Care Education/Training Program | 1500 S. Avenue K Station 3 Shroc, Portales, NM 88130 | 2018-08-16 |
| 1033611918 | Shelley Marie Laya | Student in an Organized Health Care Education/Training Program | 1500 S. Ave K., Station 3, Shroc, Portales Nm, CA 88130 | 2018-03-06 |
| 1750800744 | Sara Rose Mccarty | Student in an Organized Health Care Education/Training Program | 1500 S Ave K Station 3, Shro, Portales, NM 88130 | 2017-09-12 |
| 1528584463 | Calli Bane | Student in an Organized Health Care Education/Training Program | 1500 South Ave. K, Station 3, Shroc, Portales, NM 88130 | 2017-08-22 |
| 1700302890 | Victoria L Young | Speech-Language Pathologist | 1500 South Ave K, Station 3 Shroc, Portales, NM 88130 | 2017-08-21 |
| Find all providers in zip 88130 | ||||
| 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 |
|---|---|---|---|---|
| 1801496625 | Stephen Kreidler | Military Health Care Provider | 5453 Roosevelt Loop Ne, Rio Rancho, NM 87144-5218 | 2020-10-30 |
| 1134748692 | Patrick James Scollon | Military Health Care Provider | 104 W D. L. Ingram Ave, Cannon Afb, Nm 88101, Cannon Afb, NM 88101 | 2020-04-14 |
| 1144797556 | William Murphy Whittle | Military Health Care Provider | 2000 Hallum St, Clovis, NM 88101-8684 | 2018-10-24 |
| 1265983068 | Yurikoaokio Motomochi Livas | Military Health Care Provider | 209 Wilmington Cir, Clovis, NM 88101-9382 | 2016-10-18 |
| 1245614544 | Rowland Coyle | Military Health Care Provider | 701 Stephen Moody Rd, Albuquerque, NM 87117 | 2015-07-16 |
| 1972939585 | Eugene Navarro Tabita | Military Health Care Provider | 4050a Greenhouse Pl Se, Albuquerque, NM 87116-3008 | 2013-09-16 |
| 1043553217 | Amanda Colyer | Military Health Care Provider | 2050 2nd St Se # A, Albuquerque, NM 87117-5522 | 2013-04-05 |
| 1831438357 | John Frederick Rinaldi | Military Health Care Provider | 3500 Adenmore Ct, Apt C, Clovis, NM 88101 | 2013-02-04 |
| 1003176389 | Ricky Franco Vela | Military Health Care Provider | 8101a W Sandia Cir Se, Albuquerque, NM 87116-5501 | 2012-05-21 |
| 1740583350 | Norma P Grandberry | Military Health Care Provider | 1501 Westchester St, Clovis, NM 88101-4638 | 2010-12-21 |
| Find all providers with the same taxonomy | ||||
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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.