Jose Edwin Aviles

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

5955 Zeamer Ave
Elmendorf Afb, AK 99506-3702

Phone

(509) 715-8291

NPI assigned

Dec 5, 2018

Sex

Male

Sole proprietor

Yes

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": "1543968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1255801049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 ZEAMER AVE",
            "city": "ELMENDORF AFB",
            "state": "AK",
            "postal_code": "995063702",
            "telephone_number": "509-715-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 ZEAMER AVE",
            "city": "ELMENDORF AFB",
            "state": "AK",
            "postal_code": "995063702",
            "telephone_number": "509-715-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILES",
        "first_name": "JOSE",
        "middle_name": "EDWIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-05",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 673D Medgrp-Jber Elmndrf-Rich
• Laura Kim Abts, M.D.
• Norma Lynne Allgood, M.D.
• Lee S Astle, M.D.
• April M Azaravich
• Ashley Barasa, MD
• Richard Thomas Barker, PSY.D.
• Andrew A Beaulieu, LMSW
• Kezia Bechtoldt

• Independent Duty Medical Technicians in Elmendorf Afb, AK
• Providers in Elmendorf Afb, AK by specialty
• Independent Duty Medical Technicians in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; 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.