Matthew Robert Wilcox, IDMT

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

701 Hospital Loop
Fairchild AFB, WA 99011-8704

Phone

(509) 247-9620

NPI assigned

May 27, 2021

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

Electronic endpoints 1

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": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1447826714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 HOSPITAL LOOP",
            "city": "FAIRCHILD AFB",
            "state": "WA",
            "postal_code": "990118704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 HOSPITAL LOOP",
            "city": "FAIRCHILD AFB",
            "state": "WA",
            "postal_code": "990118704",
            "telephone_number": "509-247-9620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "MATTHEW",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "matthew.r.wilcox19.mil@mail.mil",
            "affiliation": "N",
            "endpointDescription": "Official government email",
            "address_1": "701 Hospital Loop",
            "city": "Fairchild AFB",
            "state": "WA",
            "country_code": "US",
            "postal_code": "990118704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John Edward Vickman, M.D
• Marc Palmones Villano, IDMT
• Khalil Rashaun Wallace
• Todd Samuel Weller, D.M.D.
• Ryan Werner, IDMT
• Jeff K Williams, LCSW
• Tiffany Williams, DNP
• April Lynn Witt

• Independent Duty Medical Technicians in Fairchild AFB, WA
• Providers in Fairchild AFB, WA by specialty
• Independent Duty Medical Technicians in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.