Active NPI
Derek James Adams Sr., NREMT
- Basic Emergency Medical Technician
- Fort Rucker, AL
National Provider Identifier
1417393794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Basic Emergency Medical Technician
- License
- E1820386
- Practice address
- Building 301 Andrews Ave.
Lyster Army Health Clinic
Ft. Rucker, AL 36362-5333 - Phone
- (931) 338-7965
- NPI assigned
- May 14, 2013
- 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 |
|---|---|---|---|---|
| Basic Emergency Medical Technician | 146N00000X | E1820386 | TX | Primary |
Addresses
Primary practice location
Building 301 Andrews Ave.
Lyster Army Health Clinic
Ft. Rucker, AL 36362-5333
Mailing address
Building 301 Andrews Ave.
Lyster Army Health Clinic
Ft. Rucker, AL 36362-5333
Phone (931) 338-7965
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E1820386 | TX | MD | Basic Emergency Medical Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368489600000",
"number": "1417393794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BUILDING 301 ANDREWS AVE.",
"address_2": "LYSTER ARMY HEALTH CLINIC",
"city": "FT. RUCKER",
"state": "AL",
"postal_code": "363625333",
"telephone_number": "931-338-7965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BUILDING 301 ANDREWS AVE.",
"address_2": "LYSTER ARMY HEALTH CLINIC",
"city": "FT. RUCKER",
"state": "AL",
"postal_code": "363625333",
"telephone_number": "931-338-7965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADAMS",
"first_name": "DEREK",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"credential": "NREMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-14",
"last_updated": "2013-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "146N00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Basic",
"state": "TX",
"license": "E1820386",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Rucker, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.