Samantha Crucet, IDMT

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

701 Hospital Loop
Fairchild Afb, WA 99011

Phone

(509) 247-5755

NPI assigned

Feb 1, 2012

Sex

Female

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": "1328054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363737600000",
    "number": "1205108693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 HOSPITAL LOOP",
            "city": "FAIRCHILD AFB",
            "state": "WA",
            "postal_code": "99011",
            "telephone_number": "509-247-5755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 HOSPITAL LOOP",
            "city": "FAIRCHILD AFB",
            "state": "WA",
            "postal_code": "99011",
            "telephone_number": "509-247-5755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUCET",
        "first_name": "SAMANTHA",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-01",
        "last_updated": "2013-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyse Marie Carlson, M.D.
• Claudio Alejandro Castillo, IDMT
• Sarah Collins, RN
• Mariah Combs
• Andrew Coutermarsh, DO
• Stephanie M Davis, M.D.
• Lance Bryan Derosier
• Darrian Dewald, LMFTA
• Brian Diiorio, DPT
• Nathan James Dillow, IDMT

• Independent Duty Medical Technicians in Fairchild Afb, WA
• Providers in Fairchild Afb, WA by specialty
• Independent Duty Medical Technicians in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2013; 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.