Active NPI
Andrew M Null
- Independent Duty Medical Technicians
- Cannon Afb, NM
National Provider Identifier
1205790375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Independent Duty Medical Technicians
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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.