Jeffrey C Guerttman, IDMT

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

4067 Roxbury Cir Apt B
Hill AFB, UT 84056-1346

Phone

(850) 420-3402

NPI assigned

Feb 23, 2012

Last updated

Feb 23, 2012By 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": "1329955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329955200000",
    "number": "1427322353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4067 ROXBURY CIR APT B",
            "city": "HILL AFB",
            "state": "UT",
            "postal_code": "840561346",
            "telephone_number": "850-420-3402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4067 ROXBURY CIR APT B",
            "city": "HILL AFB",
            "state": "UT",
            "postal_code": "840561346",
            "telephone_number": "850-420-3402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERTTMAN",
        "first_name": "JEFFREY",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-23",
        "last_updated": "2012-02-23",
        "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": []
}

• Peter Shigeki Frandsen, DDS
• Milagros Gargurevich, PHD
• Isaac Quinn Garrett, DMD
• Brian Caleb Greer, IDMT
• Jefferson Bayless Guenther, DDS
• Ann-Therese Guillory, RN
• Tamera Jo Hall, IDMT
• Kammi Marie Hansen, R.D.
• Jeffrey Nathan Harris, M.D.
• Tyson Hazard

• Independent Duty Medical Technicians in Hill AFB, UT
• Providers in Hill AFB, UT by specialty
• Independent Duty Medical Technicians in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; 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.