Individual provider Active NPI

Andrew M Null

  • Independent Duty Medical Technicians
  • Cannon Afb, NM
National Provider Identifier
1205790375
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty Medical TechniciansTaxonomy code 1710I1003X
Practice address
27 Somdg
224 West D.L. Ingram Ave, BLDG. 1408
Cannon Afb, NM 88103
Phone
(575) 784-2778
NPI assigned
Dec 12, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Medical Technicians 1710I1003X Primary

Addresses

Primary practice location

27 Somdg
224 West D.L. Ingram Ave, BLDG. 1408
Cannon Afb, NM 88103

Mailing address

27 Somdg
224 West D.L. Ingram Ave, BLDG. 1408
Cannon Afb, NM 88103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1765497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1205790375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 SOMDG",
            "address_2": "224 WEST D.L. INGRAM AVE, BLDG. 1408",
            "city": "CANNON AFB",
            "state": "NM",
            "postal_code": "88103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 SOMDG",
            "address_2": "224 WEST D.L. INGRAM AVE, BLDG. 1408",
            "city": "CANNON AFB",
            "state": "NM",
            "postal_code": "88103",
            "telephone_number": "575-784-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NULL",
        "first_name": "ANDREW",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-12-12",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "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": []
}

Other providers in Cannon Afb, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; 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.