Johnathan A Paxton, IDMT

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

West Perimeter Rd BLDG 1050
Malcolm Grow Medical Center
Andrews AFB, MD 20762

Phone

(240) 857-8529

NPI assigned

Apr 27, 2009

Last updated

Apr 30, 2009By 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": "1240790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241049600000",
    "number": "1376787903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 BISMARK ST",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206033820",
            "telephone_number": "240-691-6687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WEST PERIMETER RD BLDG 1050",
            "address_2": "MALCOLM GROW MEDICAL CENTER",
            "city": "ANDREWS AFB",
            "state": "MD",
            "postal_code": "20762",
            "telephone_number": "240-857-8529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAXTON",
        "first_name": "JOHNATHAN",
        "middle_name": "A",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-27",
        "last_updated": "2009-04-30",
        "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": []
}

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• Jayasree Patla, M.D.
• Angela Patrice Pettis, CRNA
• Iudok Premoe, PNP
• John C. Pritchett, D.M.D.
• Gregory Thomas Rehe, M.D.
• Christopher Clement Rhoney, IDMT

• Independent Duty Medical Technicians in Andrews AFB, MD
• Providers in Andrews AFB, MD by specialty
• Independent Duty Medical Technicians in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2009; 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.