Philip Ofimiano Borde Jr., IDMT

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

1599 Jones St
Grand Forks AFB, ND 58205

Phone

(701) 747-5193

NPI assigned

Apr 12, 2010

Last updated

Dec 15, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1194041426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1599 JONES ST",
            "address_2": "319 OMRS",
            "city": "GRAND FORKS AFB",
            "state": "ND",
            "postal_code": "58205",
            "telephone_number": "701-747-5601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1599 JONES ST",
            "city": "GRAND FORKS AFB",
            "state": "ND",
            "postal_code": "58205",
            "telephone_number": "701-747-5193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDE",
        "first_name": "PHILIP",
        "middle_name": "OFIMIANO",
        "name_suffix": "Jr.",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-12",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 319TH Medgrp-Grand Forks (Dod Grand Forks Pharmacy)
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• Joseph Roland Adamson, MD
• Pishoi S Boctor
• Jenna Marie Boyd, DPT
• Kathleen Andrea Brehm-Heitman, P.T.
• Seth Bridges, PSY.D
• Kacie M Brown
• Nicole J Chine, PT

• Independent Duty Medical Technicians in Grand Forks AFB, ND
• Providers in Grand Forks AFB, ND by specialty
• Independent Duty Medical Technicians in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.